Provider Demographics
NPI:1811988587
Name:DEWAR, THOMAS N (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:N
Last Name:DEWAR
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 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:6317 HARRIS PKWY
Practice Address - Street 2:STE. 300
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4256
Practice Address - Country:US
Practice Address - Phone:812-361-6900
Practice Address - Fax:817-522-1968
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2337207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114961903Medicaid
85Y010OtherBCBS
4235899OtherAETNA
F07089Medicare UPIN
TX114961903Medicaid