Thomas Campbell Bourland, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22690 Issued in TX

Practice address

3302 Gaston Ave
Dallas, TX 75246-2013

Phone

(214) 828-8103

Fax

(214) 828-8382

NPI assigned

Mar 31, 2008

Last updated

Mar 31, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 26, 2012 through Jan 26, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Texas a&M University System Health Science Center

  dba Texas A&M School of Dentistry

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dallas, TX
  • NPI 1912918798

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1942472956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660677",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660677",
            "telephone_number": "214-828-8103",
            "fax_number": "214-828-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462013",
            "telephone_number": "214-828-8103",
            "fax_number": "214-828-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURLAND",
        "first_name": "THOMAS",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "22690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Arthur Bourgeois
• Christina Castrichini Bourland, MD
• Emilia Bourland, MOT, OTR
• John B. Bourland Jr., M.D.
• Jonathan Richard Bourland, PA-C
• Liza P. Bourne, M.D.
• Matthew Burke Bourneuf, MD
• Lori Bourque, OPTOMETRIST
• Mamawah Isata Bourque, P.T.
• Launa Bouseman

• Oral and Maxillofacial Surgery (Dentist) in Dallas, TX
• Providers in Dallas, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.