Provider Demographics
NPI:1770038242
Name:THOMAS, RIBU (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RIBU
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
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 1:2140 BABCOCK RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4400
Mailing Address - Country:US
Mailing Address - Phone:210-614-7953
Mailing Address - Fax:210-614-4190
Practice Address - Street 1:2140 BABCOCK RD STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4400
Practice Address - Country:US
Practice Address - Phone:210-614-7953
Practice Address - Fax:210-614-4190
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1280827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist