Provider Demographics
NPI:1467552455
Name:MORGAN, THOMAS ALLEY (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALLEY
Last Name:MORGAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 JACKSON TRL
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-2214
Mailing Address - Country:US
Mailing Address - Phone:817-444-0318
Mailing Address - Fax:
Practice Address - Street 1:729 W BEDFORD EULESS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-3939
Practice Address - Country:US
Practice Address - Phone:817-285-0605
Practice Address - Fax:817-285-0630
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist