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NPI Code Detail

MEDICARE: DR. THOMAS OMAR ADJAN DDS

MEDICARE:  DR. THOMAS OMAR ADJAN  DDS
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
11223G0001XGeneral Practice Dentistry34841TX

General Provider Information

NPI Number : 1043775471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS OMAR ADJAN DDS
Provider Business Mailing Address
First Line : 6104 S 1ST ST STE 103
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4052
Country : US
Telephone Number : 512-222-9772
Fax Number :
Provider Business Practice Location Address
First Line : 6104 S 1ST ST STE 103
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4052
Country : US
Telephone Number : 512-222-9772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2019
Last Update Date : 12/23/2019

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Directions to “ DR. THOMAS OMAR ADJAN DDS” Practice Location

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