Provider Demographics
NPI:1861499063
Name:TOBIN, W DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:W
Middle Name:DENNIS
Last Name:TOBIN
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 3441
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903
Mailing Address - Country:US
Mailing Address - Phone:361-579-1361
Mailing Address - Fax:361-579-1365
Practice Address - Street 1:2700 CITIZENS PLAZA
Practice Address - Street 2:SUITE 303
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901
Practice Address - Country:US
Practice Address - Phone:361-579-1361
Practice Address - Fax:361-579-1365
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF12782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032619102Medicaid
TX032619102Medicaid
TXC43491Medicare UPIN