Provider Demographics
NPI:1720273287
Name:RICHARD D THRASHER III MD PA
Entity Type:Organization
Organization Name:RICHARD D THRASHER III MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:THRASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-458-8937
Mailing Address - Street 1:4510 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1650
Mailing Address - Country:US
Mailing Address - Phone:214-458-8937
Mailing Address - Fax:866-823-8302
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:214-458-8937
Practice Address - Fax:866-823-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194245001Medicaid
TX8F7317Medicare PIN