Provider Demographics
NPI:1609009315
Name:THOMAS, PETER FORSYTH (PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:FORSYTH
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 INTERNATIONAL PKWY STE 1010
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8346
Mailing Address - Country:US
Mailing Address - Phone:972-267-1988
Mailing Address - Fax:972-267-3434
Practice Address - Street 1:6404 INTERNATIONAL PKWY STE 1010
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8346
Practice Address - Country:US
Practice Address - Phone:972-267-1988
Practice Address - Fax:972-267-3434
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34786OtherLICENSE