MEDICARE: DR. THOMAS K HEDGE 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
1	1223G0001X	General Practice Dentistry	23106	TX

General Provider Information

NPI Number	:	1134347578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS K HEDGE DDS

Provider Business Mailing Address
First Line	:	800 BERING DR STE 340
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2131
Country	:	US
Telephone Number	:	713-782-4174
Fax Number	:	713-583-1265

Provider Business Practice Location Address
First Line	:	800 BERING DR STE 340
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2131
Country	:	US
Telephone Number	:	713-782-4174
Fax Number	:	713-583-1265

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/23/2019

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