Provider Demographics
NPI:1194882258
Name:DUNCAN, TOMMY BRENT (MD)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:BRENT
Last Name:DUNCAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4504 BOAT CLUB RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-7003
Mailing Address - Country:US
Mailing Address - Phone:817-237-4794
Mailing Address - Fax:817-237-4880
Practice Address - Street 1:3529 HERITAGE TRACE PKWY
Practice Address - Street 2:STE 137
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-0970
Practice Address - Country:US
Practice Address - Phone:817-741-7960
Practice Address - Fax:817-741-7582
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2008-12-08
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Provider Licenses
StateLicense IDTaxonomies
TXM5139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188674902Medicaid
TX8K8748Medicare PIN