Provider Demographics
NPI:1033257852
Name:MARQUARDT, THOMAS PATRICK (PHD)
Entity Type:Individual
Prefix:PROF
First Name:THOMAS
Middle Name:PATRICK
Last Name:MARQUARDT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 WHITIS AVE UNIT A
Mailing Address - Street 2:CMA 2 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-1503
Mailing Address - Country:US
Mailing Address - Phone:512-471-6831
Mailing Address - Fax:512-232-1804
Practice Address - Street 1:2504 WHITIS AVE UNIT A
Practice Address - Street 2:CMA 2 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1503
Practice Address - Country:US
Practice Address - Phone:512-471-6831
Practice Address - Fax:512-232-1804
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist