Provider Demographics
NPI:1700121753
Name:LEONARD M. THOME, M.D., P.A.
Entity type:Organization
Organization Name:LEONARD M. THOME, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-729-9114
Mailing Address - Street 1:3820 HIGHWAY 365
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-7543
Mailing Address - Country:US
Mailing Address - Phone:409-729-9114
Mailing Address - Fax:409-729-9197
Practice Address - Street 1:3820 HIGHWAY 365
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7543
Practice Address - Country:US
Practice Address - Phone:409-729-9114
Practice Address - Fax:409-729-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty