Provider Demographics
NPI:1437410057
Name:THOMPSON, AKEILA OJI (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:AKEILA
Middle Name:OJI
Last Name:THOMPSON
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 1:9695 SCHAEFER RD
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1918
Mailing Address - Country:US
Mailing Address - Phone:870-740-5998
Mailing Address - Fax:
Practice Address - Street 1:9695 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1918
Practice Address - Country:US
Practice Address - Phone:870-740-5998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1234790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN9293OtherTENNESSEE BOARD OF PHYSICAL THERAPY