Provider Demographics
NPI:1225487382
Name:THOMAS, NATALIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11500 W OLYMPIC BLVD
Mailing Address - Street 2:STE 415
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1536
Mailing Address - Country:US
Mailing Address - Phone:424-225-1845
Mailing Address - Fax:310-933-4803
Practice Address - Street 1:4321 MARSHA SHARP FWY
Practice Address - Street 2:DOOR #3
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2504
Practice Address - Country:US
Practice Address - Phone:806-788-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1234297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist