Provider Demographics
NPI:1316002900
Name:THOMAS, NANCY B (OT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 E ENNIS AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-4351
Mailing Address - Country:US
Mailing Address - Phone:972-878-0503
Mailing Address - Fax:972-878-6219
Practice Address - Street 1:1011 E ENNIS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4351
Practice Address - Country:US
Practice Address - Phone:972-878-0503
Practice Address - Fax:972-878-6219
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101615225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist