Basic Information
Provider Information
NPI: 1336432723
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAFFORD
FirstName: THOMAS
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: ATP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 604 N NOLAN RIVER RD
Address2:  
City: CLEBURNE
State: TX
PostalCode: 760337008
CountryCode: US
TelephoneNumber: 8176454718
FaxNumber: 8176412960
Practice Location
Address1: 604 N NOLAN RIVER RD
Address2:  
City: CLEBURNE
State: TX
PostalCode: 760337008
CountryCode: US
TelephoneNumber: 8176454718
FaxNumber: 8176412960
Other Information
ProviderEnumerationDate: 05/18/2011
LastUpdateDate: 05/18/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247200000X  Y Technologists, Technicians & Other Technical Service ProvidersTechnician, Other 

No ID Information.


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