Provider Demographics
NPI:1952311474
Name:HUME, THADDEUS WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:THADDEUS
Middle Name:WILLIAM
Last Name:HUME
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 1:2000 CRAWFORD ST
Mailing Address - Street 2:SUITE 1510
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:713-650-0111
Mailing Address - Fax:713-650-1837
Practice Address - Street 1:2000 CRAWFORD ST
Practice Address - Street 2:SUITE 1510
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:713-650-0111
Practice Address - Fax:713-650-1837
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0526207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114468502Medicaid
TX182088300OtherACS
TX10014494OtherAMERIGROUP
TXOODK22Medicare PIN
TX10014494OtherAMERIGROUP