Provider Demographics
NPI:1285642462
Name:WILHITE, THOMAS R (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:WILHITE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4500 S LANCASTER RD
Mailing Address - Street 2:PSYCHOLOGY SERVICE 116B
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7167
Mailing Address - Country:US
Mailing Address - Phone:817-570-2230
Mailing Address - Fax:817-570-2231
Practice Address - Street 1:6000 WESTERN PL STE 300
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4664
Practice Address - Country:US
Practice Address - Phone:817-570-2230
Practice Address - Fax:817-570-2231
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24458103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX24458OtherSTATE LICENSE NUMBER