Provider Demographics
NPI:1396906160
Name:DOUGLAS, HOWARD THOMAS III (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:THOMAS
Last Name:DOUGLAS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 GARY BURNS DR STE 160-343
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2540
Mailing Address - Country:US
Mailing Address - Phone:972-740-9360
Mailing Address - Fax:
Practice Address - Street 1:8745 GARY BURNS DR STE 160-343
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-2540
Practice Address - Country:US
Practice Address - Phone:972-740-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine