Provider Demographics
NPI:1528249943
Name:VOULOUKOS, THOMAS G (PT,OT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:G
Last Name:VOULOUKOS
Suffix:
Gender:M
Credentials:PT,OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W SAINT ELMO RD
Mailing Address - Street 2:UNIT 38
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3374
Mailing Address - Country:US
Mailing Address - Phone:337-288-5656
Mailing Address - Fax:512-373-3956
Practice Address - Street 1:411 W SAINT ELMO RD
Practice Address - Street 2:UNIT 38
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3374
Practice Address - Country:US
Practice Address - Phone:337-288-5656
Practice Address - Fax:512-373-3956
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist