Dr Thomas Charlton Diaz, DO is a medicare enrolled "Family Medicine" physician in Trophy Club, Texas. His current practice location is
945 Trophy Club Dr, Trophy Club, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 430-9111.
Dr Thomas Charlton Diaz is licensed to practice in Texas (license number T4345) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1265068118.
Physician's Profile
| Full Name | Dr Thomas Charlton Diaz |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 945 Trophy Club Dr, Trophy Club, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1265068118
- Provider Enumeration Date: 03/22/2020
- Last Update Date: 10/09/2025
Medicare PECOS Information:
- PECOS PAC ID: 3678996881
- Enrollment ID: I20230612003191
Medical Identifiers
Medical identifiers for Dr Thomas Charlton Diaz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265068118 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | T4345 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Thomas Charlton Diaz allows following entities to bill medicare on his behalf.
| Entity Name | Trend Physicians Group, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750934089
PECOS PAC ID: 9133553498
Enrollment ID: O20191220000140 |
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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. Dr Thomas Charlton Diaz 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 |
|---|
Dr Thomas Charlton Diaz, DO
900 8th Ave,
Fort Worth, TX 76104-3902
Ph: (817) 336-2100 | Dr Thomas Charlton Diaz, DO
945 Trophy Club Dr,
Trophy Club, TX 76262-5580
Ph: (817) 430-9111 |
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