MEDICARE: THOMAS MICHAEL DIXON M.D.

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	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	K8621	TX
2	2086S0122X	Plastic and Reconstructive Surgery Physician	K8621	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

General Provider Information

NPI Number	:	1386625713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS MICHAEL DIXON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 30033
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79120-0033
Country	:	US
Telephone Number	:	806-242-2001
Fax Number	:	806-202-2006

Provider Business Practice Location Address
First Line	:	3501 SONCY
Second Line	:	SUITE 1001
City	:	AMARILLO
State	:	TX
Zip	:	79119-4932
Country	:	US
Telephone Number	:	806-242-2001
Fax Number	:	806-202-2006

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

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	03/11/2010

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