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:
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Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215057278 NPPES
Texas MEDICAID 197025301
Texas Other 8Y8828
Texas Other P00824014

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