Provider Demographics
NPI:1568437523
Name:THOMAS J. LANDRY & ASSOCIATES, INC
Entity Type:Organization
Organization Name:THOMAS J. LANDRY & ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:337-364-5467
Mailing Address - Street 1:600 RUE DE BRILLE
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2122
Mailing Address - Country:US
Mailing Address - Phone:337-364-5467
Mailing Address - Fax:337-365-3233
Practice Address - Street 1:600 RUE DE BRILLE
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2122
Practice Address - Country:US
Practice Address - Phone:337-364-5467
Practice Address - Fax:337-365-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPT00304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C459Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER