Healthcare Provider Details

I. General information

NPI: 1548814932
Provider Name (Legal Business Name): ELSA THOMAS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 FIELDER NORTH PLZ
ARLINGTON TX
76012-2309
US

IV. Provider business mailing address

520 FIELDER NORTH PLZ
ARLINGTON TX
76012-2309
US

V. Phone/Fax

Practice location:
  • Phone: 817-461-4257
  • Fax: 817-461-4865
Mailing address:
  • Phone: 817-461-4257
  • Fax: 817-461-4865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1329494
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: