Individual provider Active NPI

Danny Ray Thomas, MD

  • Dermatology Physician
  • Benbrook, TX
National Provider Identifier
1174687651
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
F4595 Issued in TX
Practice address
6100 Southwest Blvd
Suite 100
Benbrook, TX 76109-3930
Phone
(817) 989-1595
Fax
(817) 989-1175
NPI assigned
Dec 20, 2006
Last updated
Aug 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F4595 TX Primary

Addresses

Primary practice location

6100 Southwest Blvd
Suite 100
Benbrook, TX 76109-3930

Mailing address

6100 Southwest Blvd
Suite 100
Benbrook, TX 76109-3930
Phone (817) 989-1595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000181 TX Practitioner - Dermatology 3072789809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Aug 1, 2015 Accepting new patients
Danny R. Thomas, M.D., P.a. Dermatology PastSince Oct 21, 2011 Accepting new patients

Locations

6100 Southwest Blvd
Ste 100
Benbrook, TX 76109
Phone (817) 989-1221

2321 Ira E Woods Ave
Ste 180
Grapevine, TX 76051
Phone (817) 329-2263

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1174687651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SOUTHWEST BLVD",
            "address_2": "SUITE 100",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761093930",
            "telephone_number": "817-989-1595",
            "fax_number": "817-989-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 SOUTHWEST BLVD",
            "address_2": "SUITE 100",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761093930",
            "telephone_number": "817-989-1595",
            "fax_number": "817-989-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DANNY",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F4595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benbrook, TX

Sources for this page

Verify at the official NPI Registry.