Provider Demographics
NPI:1407854011
Name:AMON, THOMAS D (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:D
Last Name:AMON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:509 E BYRON NELSON BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6183
Mailing Address - Country:US
Mailing Address - Phone:817-490-6200
Mailing Address - Fax:682-831-1200
Practice Address - Street 1:509 E. BYRON NELSON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76262-6702
Practice Address - Country:US
Practice Address - Phone:817-490-6200
Practice Address - Fax:682-831-1200
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor