Individual
DR. BRETT MCKINNEY THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 FERRIS AVENUE, SUITE I, WAXAHACHIE, TX 75165
(972) 937-1613
(972) 923-7190
Mailing address
201 FERRIS AVE STE I, WAXAHACHIE, TX 75165-3660
(972) 937-1613
(972) 923-7190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G0195
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114635902
—
TX
Enumeration date
07/02/2006
Last updated
11/20/2009
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