NPIMap

Organization Active NPI

Carroll W. Thornburg D.O.,P.a.

  • Addiction Medicine (Family Medicine) Physician
  • El Paso, TX
National Provider Identifier
1639368764
Registry record updated Jun 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
G9230 Issued in TX
Legal business name
CARROLL W. THORNBURG D.O.,P.A.
Practice address
725 S Mesa Hills Dr
Suite 1, BLDG. 1
El Paso, TX 79912-5568
Phone
(915) 887-3414
Fax
(915) 585-1682
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2016

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

Authorized official

Name
Dr. Carroll Wayne Thornburg, D.O
Title
Physician/Owner
Phone
(915) 842-0990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X G9230 TX Primary

Addresses

Primary practice location

725 S Mesa Hills Dr
Suite 1, BLDG. 1
El Paso, TX 79912-5568

Mailing address

725 S Mesa Hills Dr
Suite 1, BLDG. 1
El Paso, TX 79912-5568
Phone (915) 887-3414

National Provider Directory

National Provider Directory

Locations

725 S Mesa Hills Dr
Ste 1
El Paso, TX 79912
Phone (915) 842-0990

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466294400000",
    "number": "1639368764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S MESA HILLS DR",
            "address_2": "SUITE 1, BLDG. 1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125568",
            "telephone_number": "915-887-3414",
            "fax_number": "915-585-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S MESA HILLS DR",
            "address_2": "SUITE 1, BLDG. 1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125568",
            "telephone_number": "915-887-3414",
            "fax_number": "915-585-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL W. THORNBURG D.O.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2016-06-19",
        "status": "A",
        "authorized_official_last_name": "THORNBURG",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "915-842-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "TX",
            "license": "G9230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.