Individual
THOMAS ELDEN DEPORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6300 RIDGLEA PL STE 415, FORT WORTH, TX 76116-5706
(817) 377-1333
(817) 377-0420
Mailing address
6300 RIDGLEA PL STE 415, FORT WORTH, TX 76116-5706
(817) 377-1333
(817) 377-0420
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H9063
TX
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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