Provider Demographics
NPI:1588978068
Name:THOMAS L REID PTPC
Entity type:Organization
Organization Name:THOMAS L REID PTPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:REID
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:817-444-8827
Mailing Address - Street 1:408 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-3140
Mailing Address - Country:US
Mailing Address - Phone:817-444-8827
Mailing Address - Fax:817-444-8847
Practice Address - Street 1:408 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-3140
Practice Address - Country:US
Practice Address - Phone:817-444-8827
Practice Address - Fax:817-444-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX603330000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX650423Medicare PIN