Individual
DR. TIFFANY NICHOLE THOMURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8535 TOM SLICK, SAN ANTONIO, TX 78229-3367
(210) 582-6440
(210) 692-9021
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(210) 491-9400
(210) 491-3550
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
P4521
TX
2084P0804X
Child & Adolescent Psychiatry Physician
P4521
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C2248
MEDICARE
TX
05
—
322139205
—
TX
Enumeration date
09/23/2008
Last updated
07/08/2020
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