Provider Demographics
NPI:1790948156
Name:KILLIAN, THOMAS JOSEPH (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:KILLIAN
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:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:HUNT
Mailing Address - State:TX
Mailing Address - Zip Code:78024-0470
Mailing Address - Country:US
Mailing Address - Phone:830-329-6119
Mailing Address - Fax:
Practice Address - Street 1:1331 BANDERA HWY
Practice Address - Street 2:SUITE 1A
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-9515
Practice Address - Country:US
Practice Address - Phone:830-896-8001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9202207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE0008413OtherDPS REGISTRATION
TXD9202OtherSTATE LICENSE NUMBER
TXD9202OtherSTATE LICENSE NUMBER