Individual
THOM L GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
13501 PARK VISTA BLVD, SUITE 150, FORT WORTH, TX 76177-3203
(817) 837-8622
(866) 423-2979
Mailing address
13501 PARK VISTA BLVD, SUITE 150, FORT WORTH, TX 76177-3203
(817) 837-8622
(866) 423-2979
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
24473
TX
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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