Provider Demographics
NPI:1326539149
Name:THOMAS, MORGAN KATHREAN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:KATHREAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 PALUXY HWY
Mailing Address - Street 2:
Mailing Address - City:TOLAR
Mailing Address - State:TX
Mailing Address - Zip Code:76476-6616
Mailing Address - Country:US
Mailing Address - Phone:817-408-0643
Mailing Address - Fax:
Practice Address - Street 1:6220 PALUXY HWY
Practice Address - Street 2:
Practice Address - City:TOLAR
Practice Address - State:TX
Practice Address - Zip Code:76476-6616
Practice Address - Country:US
Practice Address - Phone:817-408-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician