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NPI Code Detail

MEDICARE: STACEY KATHERINE THOMAS

MEDICARE: STACEY KATHERINE THOMAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist119932TX

General Provider Information

NPI Number : 1093365520
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY KATHERINE THOMAS
Provider Business Mailing Address
First Line : 4225 GUADALUPE ST
Second Line :
City : AUSTIN
State : TX
Zip : 78751-4224
Country : US
Telephone Number : 832-567-8253
Fax Number :
Provider Business Practice Location Address
First Line : 4225 GUADALUPE ST
Second Line :
City : AUSTIN
State : TX
Zip : 78751-4224
Country : US
Telephone Number : 832-567-8253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2019
Last Update Date : 12/30/2025

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Directions to “ STACEY KATHERINE THOMAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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