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NPI Code Detail

MEDICARE: TANISHA THALIA THERMIDOR DPT

MEDICARE:   TANISHA THALIA THERMIDOR  DPT
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
1225100000XPhysical TherapistPT35025FL
2225100000XPhysical Therapist1348327TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316580020
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANISHA THALIA THERMIDOR DPT
Provider Business Mailing Address
First Line : PO BOX 306393
Second Line :
City : NASHVILLE
State : TN
Zip : 37230-6393
Country : US
Telephone Number : 615-373-1350
Fax Number : 615-373-7116
Provider Business Practice Location Address
First Line : 2735 TOWN CENTER BLVD N STE N
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-2595
Country : US
Telephone Number : 281-728-7734
Fax Number : 281-407-3686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2019
Last Update Date : 12/20/2021

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Directions to “ TANISHA THALIA THERMIDOR DPT” Practice Location

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