Basic Information
Provider Information
NPI: 1750342978
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUGINSKI
FirstName: THOMAS
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8915 SHADY LEAF
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782545533
CountryCode: US
TelephoneNumber: 2106800693
FaxNumber:  
Practice Location
Address1: 3551 ROGER BROOKE DR
Address2:  
City: JBSA FT SAM HOUSTON
State: TX
PostalCode: 782344504
CountryCode: US
TelephoneNumber: 2109162203
FaxNumber: 2109163833
Other Information
ProviderEnumerationDate: 03/29/2006
LastUpdateDate: 03/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XL4349TXN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0600X28123MNN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
2084N0600XL4349TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology

No ID Information.


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