Provider Demographics
NPI:1407896848
Name:EARLE S THORNHILL, M.D.
Entity Type:Organization
Organization Name:EARLE S THORNHILL, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EARLE
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:THORNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-212-1533
Mailing Address - Street 1:7760 N LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-3054
Mailing Address - Country:US
Mailing Address - Phone:409-212-1533
Mailing Address - Fax:409-212-1770
Practice Address - Street 1:7760 N LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-3054
Practice Address - Country:US
Practice Address - Phone:409-212-1533
Practice Address - Fax:409-212-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0041PUOtherBLUE CROSS
TXDF1080OtherMEDICARE RAILROAD
TXDF1080OtherMEDICARE RAILROAD
TXI32278Medicare UPIN