MEDICARE: DR. THOMAS RICHARD COLE 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	7665	MN

General Provider Information

NPI Number	:	1699882241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS RICHARD COLE DDS

Provider Business Mailing Address
First Line	:	2732 FRONTIER
Second Line	:
City	:	SPRING BRANCH
State	:	TX
Zip	:	78070
Country	:	US
Telephone Number	:	210-221-9939
Fax Number	:	210-221-9943

Provider Business Practice Location Address
First Line	:	1400 GRAYSON ST
Second Line	:	BLDG 44, SUITE 213
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-7577
Country	:	US
Telephone Number	:	210-221-9939
Fax Number	:	210-221-9943

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/08/2007

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