Provider Demographics
NPI:1750973988
Name:WOLFE, THOMAS (PT, DPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:WOLFE
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 1:10706 LAKE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-2656
Mailing Address - Country:US
Mailing Address - Phone:512-964-1844
Mailing Address - Fax:833-201-5490
Practice Address - Street 1:27320 RANCH ROAD 12 STE A
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4962
Practice Address - Country:US
Practice Address - Phone:512-964-1844
Practice Address - Fax:833-201-5490
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1342296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist