MEDICARE: DR. THOMAS N DEWAR 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	207RG0100X	Gastroenterology Physician	H2337	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	85Y010	OTHER	BCBS
3	4235899	OTHER	AETNA

General Provider Information

NPI Number	:	1811988587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS N DEWAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 35629
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-0629
Country	:	US
Telephone Number	:	214-424-2200
Fax Number	:	214-231-2159

Provider Business Practice Location Address
First Line	:	6317 HARRIS PKWY
Second Line	:	STE. 300
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4256
Country	:	US
Telephone Number	:	812-361-6900
Fax Number	:	817-522-1968

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	11/06/2017

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