Provider Demographics
NPI:1619924529
Name:THORNTON, STEVEN JACKSON (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JACKSON
Last Name:THORNTON
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 1:7115 GREENVILLE AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5103
Mailing Address - Country:US
Mailing Address - Phone:214-265-3200
Mailing Address - Fax:214-265-3285
Practice Address - Street 1:7115 GREENVILLE AVE
Practice Address - Street 2:STE 310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5100
Practice Address - Country:US
Practice Address - Phone:214-265-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1479207XX0005X, 207X00000X, 207XX0005X, 207XX0801X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168092801Medicaid
TX168092802Medicaid
TX8K1803OtherBCBS
TX8BZ909OtherBCBS
TXP00771564Medicare PIN
I15311Medicare UPIN
TX8C2068Medicare PIN
TX168092801Medicaid
TXP00267473Medicare PIN