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Individual
THOMAS LEROY BAXTER III
Active
Individual
THOMAS LEROY BAXTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F0869
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033036703
—
TX
01
—
1154480689
BLUE CROSS BLUE SHIELD
TX
05
—
33036702
—
TX
01
—
P00757544
MEDICARE RAILROAD
TX
01
—
P01030939
RR MEDICARE
TX
Enumeration date
12/08/2006
Last updated
06/13/2012
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