Provider Demographics
NPI:1417337742
Name:WOMACK, THOMAS III
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:WOMACK
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DIAMOND OAK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3454
Mailing Address - Country:US
Mailing Address - Phone:281-674-8643
Mailing Address - Fax:888-633-6640
Practice Address - Street 1:7501 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1938
Practice Address - Country:US
Practice Address - Phone:281-674-8643
Practice Address - Fax:888-633-6640
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other