Provider Demographics
NPI:1639292683
Name:RAIN, THOMAS EDWIN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWIN
Last Name:RAIN
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 1:14700 MARSH LN
Mailing Address - Street 2:# 1029
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-5500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14700 MARSH LN
Practice Address - Street 2:# 1029
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-5500
Practice Address - Country:US
Practice Address - Phone:972-243-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0630208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery