Provider Demographics
NPI:1588844575
Name:THOMAS R WATKINS,DDS AND ASSOCIATES
Entity Type:Organization
Organization Name:THOMAS R WATKINS,DDS AND ASSOCIATES
Other - Org Name:W DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-523-0000
Mailing Address - Street 1:8744 GRISSOM RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4819
Mailing Address - Country:US
Mailing Address - Phone:210-523-0000
Mailing Address - Fax:210-523-0067
Practice Address - Street 1:8744 GRISSOM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4819
Practice Address - Country:US
Practice Address - Phone:210-523-0000
Practice Address - Fax:210-523-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 125191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty