Provider Demographics
NPI:1518565647
Name:THOMPSON, MIRIAM KUMARI (PT)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:KUMARI
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10832 PATTON DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-3391
Mailing Address - Country:US
Mailing Address - Phone:678-764-2885
Mailing Address - Fax:
Practice Address - Street 1:10832 PATTON DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-3391
Practice Address - Country:US
Practice Address - Phone:678-764-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist