Healthcare Provider Details

I. General information

NPI: 1801751219
Provider Name (Legal Business Name): KIMBERLY LYNN THOMAS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 W RALPH HALL PKWY STE 105
ROCKWALL TX
75032-8707
US

IV. Provider business mailing address

PO BOX 162
CELINA TX
75009-0162
US

V. Phone/Fax

Practice location:
  • Phone: 972-772-8484
  • Fax:
Mailing address:
  • Phone: 469-954-0506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number40492
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: