Active NPI
Thomas Scott Douglass III, MD
- Occupational Medicine Physician
- Montgomery, TX
National Provider Identifier
1669495990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 22294
- Practice address
- 28827 Diamondhead So
Montgomery, TX 77356-2814 - Phone
- (218) 780-3117
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 22294 | MN | Primary |
Addresses
Primary practice location
28827 Diamondhead So
Montgomery, TX 77356-2814
Mailing address
28827 Diamondhead So
Montgomery, TX 77356-2814
Phone (218) 780-3117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 969327100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22294 | MN | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1669495990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28827 DIAMONDHEAD SO",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773562814",
"telephone_number": "218-780-3117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28827 DIAMONDHEAD SO",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773562814",
"telephone_number": "218-780-3117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "THOMAS",
"middle_name": "SCOTT",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "MN",
"license": "22294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "969327100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.