Active NPI
Thomas B Sulistio, MD
- Specialist
- Denison, TX
National Provider Identifier
1851378079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- G4408
- Practice address
- 1000 Memorial Dr
Denison, TX 75020-2035 - Phone
- (903) 416-4000
- Fax
- (903) 327-8023
- NPI assigned
- Dec 29, 2005
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | G4408 | TX | Primary |
Addresses
Primary practice location
1000 Memorial Dr
Denison, TX 75020-2035
Mailing address
1302 N State Highway 91
Denison, TX 75020-1167
Phone (903) 465-1857
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 |
|---|---|---|---|
| G4408 | TX | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Associates of Denison, LLP | Specialist | Past | Accepting new patients |
| C David Garvin, MD, PA | Specialist | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIAEAD
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 and National Provider Directory roles.
-
- Specialist
- Denison, TX
- NPI 1588767834
-
- Specialist
- Bonham, TX
- NPI 1063528461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1851378079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1302 N STATE HIGHWAY 91",
"city": "DENISON",
"state": "TX",
"postal_code": "750201167",
"telephone_number": "903-465-1857",
"fax_number": "903-327-8023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MEMORIAL DR",
"city": "DENISON",
"state": "TX",
"postal_code": "750202035",
"telephone_number": "903-416-4000",
"fax_number": "903-327-8023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULISTIO",
"first_name": "THOMAS",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "G4408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.