Provider Demographics
NPI:1417995044
Name:RAPER, THOMAS BRADLEY (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:BRADLEY
Last Name:RAPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 560
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4159
Mailing Address - Country:US
Mailing Address - Phone:469-916-0087
Mailing Address - Fax:469-916-0089
Practice Address - Street 1:8220 WALNUT HILL LN STE 408
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4417
Practice Address - Country:US
Practice Address - Phone:214-361-9777
Practice Address - Fax:214-891-0084
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9442207RP1001X, 207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174408803Medicaid
TXTXB107870Medicare PIN