Provider Demographics
NPI:1629156765
Name:RAETZSCH, THOMAS HAYS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HAYS
Last Name:RAETZSCH
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 1:1025 N AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-4517
Mailing Address - Country:US
Mailing Address - Phone:830-305-1595
Mailing Address - Fax:830-303-2314
Practice Address - Street 1:1025 N AUSTIN ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-4517
Practice Address - Country:US
Practice Address - Phone:830-379-1184
Practice Address - Fax:830-303-2314
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110614801Medicaid
TXB25736Medicare UPIN
TX110614801Medicaid