Provider Demographics
NPI:1447225982
Name:DEMOOR, THOMAS M (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:DEMOOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:9150 HUEBNER RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1558
Mailing Address - Country:US
Mailing Address - Phone:210-877-9046
Mailing Address - Fax:210-877-9052
Practice Address - Street 1:9150 HUEBNER RD
Practice Address - Street 2:205
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1558
Practice Address - Country:US
Practice Address - Phone:210-877-9046
Practice Address - Fax:210-877-9052
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2016-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH23332084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139955223Medicaid
TXE51571Medicare UPIN
TX139955206Medicaid