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General NPI Number Information
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NPI Number | 1295568673
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Entity Type | Individual
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Provider Name | TE'ARA L THOMPSON DPT
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Gender | Female
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Dates
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Enumeration Date | 08/22/2024
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1650 REPUBLIC PKWY
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City | MESQUITE
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State | TX
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Zip | 75150-6916
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Country | US
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Telephone | 972-698-1140
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Fax | 972-681-8753
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Provider Business Mailing Address
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Address Line | 3302 WESLEY ST
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City | PASCAGOULA
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State | MS
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Zip | 39567-4535
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Country | US
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Telephone | 228-235-8547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP033646T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7838
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License Number State | MS
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