Doctor Name: | DR. PRASERT THAMMASITHIBOON |
NPI Number: | 1669439162 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | F1271 |
Business Practice Address: | 387 W I H 10 Fort Stockton, TX - 797352700 |
Business Phone Number: | 4323362067 |
Business Fax Number: | 4323364511 |
Mailing Address: | 387 W I H 10, Po Box 1060 FORT STOCKTON |
State: | TX |
Postal Code: | 797352700 |
Phone Number: | 4323362067 |
Fax Number: | 4323364511 |
NPI Enumeration Date: | 04/27/2006 |
NPI Last Update Date: | 11/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | F1271 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |