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General NPI Number Information
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NPI Number | 1417954728
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Entity Type | Individual
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Provider Name | THOMAS GRAY HARDAWAY II M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3030 NACOGDOCHES RD SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217-4540
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Country | US
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Telephone | 210-826-9599
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Fax | 210-826-9828
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Provider Business Mailing Address
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Address Line | 3030 NACOGDOCHES RD SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78217-4540
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Country | US
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Telephone | 210-826-9599
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Fax | 210-826-9828
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H4947
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | H4947
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License Number State | TX
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