Dr. Thomas Richard Stark
Pediatric Dentist Orofacial Pain
3551 Roger Brooke Dr
San Antonio
, Texas 78234-4504
Dr. Thomas Richard Stark
Pediatric Dentist Orofacial Pain
3551 Roger Brooke Dr
San Antonio
, Texas 78234-4504
(210) 539-9582
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About
Features
Specialties
- Pediatric Dentist
- Orofacial Pain
Languages spoken
- English
Location
First Address
- Dr. Thomas Richard Stark
- 3551 Roger Brooke Dr
- San Antonio, TX
- Zip : 78234-4504
- Phone : (210) 539-9582
Second Address
- Dr. Thomas Richard Stark
- 3551 Roger Brooke Dr
- San Antonio, TX
- Zip : 78234-4504
- Phone : (210) 539-9582
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223P0221X | Pediatric Dentist | 21135 | TX |
| Y | 1223X2210X | Orofacial Pain | 21135 | TX |
National Provider Identifier
| NPI | 1013952266 |
|---|---|
| Provider Name | Dr. Thomas Richard Stark |
| First Address | San Antonio, TX 78234-4504 |
| Second Address | San Antonio, TX 78234-4504 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/06/2006 |
| Last Update Date | 18/10/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.