Provider Demographics
NPI:1417960345
Name:THOMAS, BETSY BODI (PT MS)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:BODI
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 N COLLINS BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3562
Mailing Address - Country:US
Mailing Address - Phone:972-235-6684
Mailing Address - Fax:972-644-7729
Practice Address - Street 1:1755 N COLLINS BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3562
Practice Address - Country:US
Practice Address - Phone:972-235-6684
Practice Address - Fax:972-644-7729
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1085140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist