Diver, Thomas E
Diver, Thomas E is an individual health care provider with primary practice located at 855 Montgomery , Fort Worth TX 76107-2553. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Diver, Thomas E can be contacted via phone (817) 735-2228.Contact Information
Primary practice address
855 Montgomery
Fort Worth TX 76107-2553
Phone: (817) 735-2228
Fax: (817) 735-2582
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA01931 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA01931 | Texas |
Profile Details
| NPI number | 1215057278 |
|---|---|
| LBN Legal business name | Diver, Thomas E |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Jun 25th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215057278 | NPPES |
| Texas | MEDICAID | 197025301 | |
| Texas | Other | 8Y8828 | |
| Texas | Other | P00824014 |
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