Provider Demographics
NPI:1356416358
Name:BYRNE, THOMAS M (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:BYRNE
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 1:16611 X ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-2373
Mailing Address - Country:US
Mailing Address - Phone:402-894-1426
Mailing Address - Fax:
Practice Address - Street 1:18018 BURKE STREET
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4417
Practice Address - Country:US
Practice Address - Phone:402-573-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19449208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1200088Medicaid
NE1200732Medicaid
NE00031OtherBCBS OF NE
NE1200731Medicaid
NE1200730Medicaid
NE1201170Medicaid
IA0929240Medicaid
NE1201451Medicaid
NE1628OtherMIDLANDS CHOICE
NE1201169Medicaid
NE1201451Medicaid