Individual
MR. THANAPOOM BOONIPAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1100
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
28451
MN
208200000X
Plastic Surgery Physician
64276
MN
208200000X
Plastic Surgery Physician
Primary
U9214
TX
Other
Enumeration date
03/24/2017
Last updated
12/20/2024
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