Provider Demographics
NPI:1679020325
Name:TOM W. WATSON, D.D.S.
Entity Type:Organization
Organization Name:TOM W. WATSON, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMME
Authorized Official - Suffix:
Authorized Official - Credentials:FINANCIAL
Authorized Official - Phone:972-270-2911
Mailing Address - Street 1:3133 N TOWN EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3920
Mailing Address - Country:US
Mailing Address - Phone:972-270-2911
Mailing Address - Fax:972-270-0798
Practice Address - Street 1:3133 N TOWN EAST BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3920
Practice Address - Country:US
Practice Address - Phone:972-270-2911
Practice Address - Fax:972-270-0798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9269261QD0000X
TX8115261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental