Provider Demographics
NPI:1538381876
Name:HESSE, THOMAS MICHAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:HESSE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:TOM
Other - Middle Name:M
Other - Last Name:HESSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:805 E TAHOKA RD
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79316-3635
Mailing Address - Country:US
Mailing Address - Phone:806-637-3533
Mailing Address - Fax:806-637-4212
Practice Address - Street 1:805 E TAHOKA RD
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-3635
Practice Address - Country:US
Practice Address - Phone:806-637-3533
Practice Address - Fax:806-637-4212
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist