Provider Demographics
NPI:1154952323
Name:THOMAS, BECKY YVONNE (COSMETOLOGIST)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:YVONNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 LAND RUSH DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-5522
Mailing Address - Country:US
Mailing Address - Phone:817-825-2662
Mailing Address - Fax:817-538-5159
Practice Address - Street 1:124 W PIPELINE RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-5735
Practice Address - Country:US
Practice Address - Phone:817-825-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1442910174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty