Miss Tamara Idette Thorn, MSW, LCSW, PA-C is a medicare enrolled "Physician Assistant" provider in Dallas, Texas. Her current practice location is
4645 Samuell Blvd, Metrocare Services, Dallas, Texas. You can reach out to her office (for appointments etc.) via phone at
(214) 743-1200.
Miss Tamara Idette Thorn is licensed to practice in Texas (license number PA07340) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1548320823.
Healthcare Provider's Profile
Full Name | Miss Tamara Idette Thorn |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 4645 Samuell Blvd, Dallas, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548320823
- Provider Enumeration Date: 12/09/2006
- Last Update Date: 08/24/2011
Medicare PECOS Information:
- PECOS PAC ID: 2961421474
- Enrollment ID: I20100430000554
Medical Identifiers
Medical identifiers for Miss Tamara Idette Thorn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548320823 | NPI | - | NPPES |
6003179 | Medicaid | NC | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | C004844 (North Carolina) | Secondary |
1041C0700X | Social Worker - Clinical | 8654 (South Carolina) | Secondary |
363AM0700X | Physician Assistant - Medical | 005697 (Georgia) | Secondary |
363A00000X | Physician Assistant | 005697 (Georgia) | Secondary |
363A00000X | Physician Assistant | PA07340 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Tamara Idette Thorn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Miss Tamara Idette Thorn, MSW, LCSW, PA-C 4645 Samuell Blvd, Metrocare Services, Dallas, TX 75228-6826 Ph: (704) 820-4933 | Miss Tamara Idette Thorn, MSW, LCSW, PA-C 4645 Samuell Blvd, Metrocare Services, Dallas, TX 75228-6826 Ph: (214) 743-1200 |
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