MEDICARE: THOMAS J. PURGASON, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	F4394	TX

General Provider Information

NPI Number	:	1467640870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS J. PURGASON, M.D., P.A.

Provider Business Mailing Address
First Line	:	3600 MATLOCK RD
Second Line	:	SUITE 100
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3679
Country	:	US
Telephone Number	:	817-465-8855
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 MATLOCK RD
Second Line	:	SUITE 100
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3679
Country	:	US
Telephone Number	:	817-465-8855
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. THOMAS J. PURGASON
Credential	:	M.D.
Telephone Number	:	817-465-8855

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	10/10/2007

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