Provider Demographics
NPI:1710239900
Name:THOMAS C. WASCHER, M.D.
Entity Type:Organization
Organization Name:THOMAS C. WASCHER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WASCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-225-3524
Mailing Address - Street 1:2221 BUENA VISTA ST.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3702
Mailing Address - Country:US
Mailing Address - Phone:210-225-3524
Mailing Address - Fax:210-225-2081
Practice Address - Street 1:2221 BUENA VISTA ST.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3702
Practice Address - Country:US
Practice Address - Phone:210-225-3524
Practice Address - Fax:210-225-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7358208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092621401Medicaid
B27429Medicare UPIN