Thaddeus R Tregeagle, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

26566 Issued in TX

Practice address

9135 Schaefer Rd
3
Converse, TX 78109

Phone

(210) 607-8232

Fax

(210) 368-2132

NPI assigned

Jul 17, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Thad R Tregeagle Other name

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1891925491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9135 SCHAEFER RD",
            "address_2": "3",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781091979",
            "telephone_number": "210-607-8232",
            "fax_number": "210-368-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SCHAEFER RD",
            "address_2": "3",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "78109",
            "telephone_number": "210-607-8232",
            "fax_number": "210-368-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREGEAGLE",
        "first_name": "THADDEUS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "26566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAD",
            "last_name": "TREGEAGLE",
            "middle_name": "R",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Converse, TX
• Providers in Converse, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.