Healthcare Provider Details

I. General information

NPI: 1316549967
Provider Name (Legal Business Name): KRISTIN ANNE THOMAS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W HAMPDEN AVE
ENGLEWOOD CO
80110-2401
US

IV. Provider business mailing address

3828 EL CAMPO AVE
FORT WORTH TX
76107-4515
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-0772
  • Fax:
Mailing address:
  • Phone: 214-498-1894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2148374
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: