| Larry D Thomas Phd Inc | |
|
2211 S Day St Suite 405 Brenham TX 77833-5583 | |
| (979) 830-7080 | |
| (979) 830-7124 |
| Full Name | Larry D Thomas Phd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2211 S Day St, Brenham, Texas |
| Authorized Official Name and Position | Larry D Thomas (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 9798307080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry D Thomas Phd Inc 2211 S Day St Suite 405 Brenham TX 77833-0901 Ph: (979) 830-7080 | Larry D Thomas Phd Inc 2211 S Day St Suite 405 Brenham TX 77833-5583 Ph: (979) 830-7080 |
| NPI Number | 1194912105 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 12/29/2010 |
| Medicare PECOS PAC ID | 3072639582 |
|---|---|
| Medicare Enrollment ID | O20100921001455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194912105 | NPI | - | NPPES |
| 0802399-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 12195 (Texas) | Primary |
| Provider Name | Larry D Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508862780 PECOS PAC ID: 2062538572 Enrollment ID: I20100921001465 |
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