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General NPI Number Information
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NPI Number | 1972078236
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Entity Type | Individual
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Provider Name | THOMAS WARREN FIELDING ATC
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Gender | Male
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 341 US HIGHWAY 287
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City | BOWIE
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State | TX
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Zip | 76230-5963
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Country | US
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Telephone | 940-872-1154
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 HARRISON ST APT 143
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City | WICHITA FALLS
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State | TX
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Zip | 76308-1354
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Country | US
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Telephone | 940-867-6020
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT7444
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License Number State | TX
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