Provider Demographics
NPI:1356411649
Name:MINOR, THOMAS XAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:XAVIER
Last Name:MINOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:782 MEDICAL CENTER DRIVE E SUITE 311
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611
Mailing Address - Country:US
Mailing Address - Phone:559-472-4606
Mailing Address - Fax:559-472-4608
Practice Address - Street 1:782 MEDICAL CENTER DRIVE E SUITE 311
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611
Practice Address - Country:US
Practice Address - Phone:559-472-4606
Practice Address - Fax:559-472-4608
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2023-04-12
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Provider Licenses
StateLicense IDTaxonomies
CAA78051208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA78051OtherMEDICAL LICENSE
CAZZZ02592ZOtherVALLEY UROLOGY MEDICARE PTAN