Provider Demographics
NPI:1770506511
Name:GINN, THOMAS ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:GINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3201 UNIVERSITY DR E
Mailing Address - Street 2:STE 345
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3484
Mailing Address - Country:US
Mailing Address - Phone:979-776-5120
Mailing Address - Fax:979-731-8105
Practice Address - Street 1:3201 UNIVERSITY DR E
Practice Address - Street 2:STE 345
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3475
Practice Address - Country:US
Practice Address - Phone:979-776-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF3999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00158864OtherRAILROAD MEDICARE
TX8AJ178OtherBCBS
TX100069702Medicaid
TXB22990Medicare UPIN
TX100069702Medicaid