Provider Demographics
NPI:1265556567
Name:WERNER, THOMAS P (PT, PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:WERNER
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4688
Mailing Address - Street 2:
Mailing Address - City:INCLINE VILLAGE
Mailing Address - State:NV
Mailing Address - Zip Code:89450-4688
Mailing Address - Country:US
Mailing Address - Phone:775-745-5695
Mailing Address - Fax:
Practice Address - Street 1:5000 BEE CAVE RD STE 204
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5254
Practice Address - Country:US
Practice Address - Phone:512-329-6617
Practice Address - Fax:512-329-6772
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13162225100000X
NV0440225100000X
TX1194947225100000X
WI2815-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100814Medicare UPIN
NV38258Medicare UPIN