MEDICARE: THOMAS M DEBERARDINO MD

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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	Q9597	TX
2	207X00000X	Orthopaedic Surgery Physician	Q9597	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033191176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS M DEBERARDINO MD

Provider Business Mailing Address
First Line	:	8300 FLOYD CURL DR FL 3
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3931
Country	:	US
Telephone Number	:	210-450-9300
Fax Number	:	210-450-6023

Provider Business Practice Location Address
First Line	:	7946 N LOOP 1604 W
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-5174
Country	:	US
Telephone Number	:	210-567-9040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	05/04/2026

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Directions to “ THOMAS M DEBERARDINO MD” Practice Location

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