Provider Demographics
NPI:1992350862
Name:THOMASSON, JANCI K
Entity type:Individual
Prefix:
First Name:JANCI
Middle Name:K
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANCI
Other - Middle Name:K
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4601 HARTFORD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4603
Mailing Address - Country:US
Mailing Address - Phone:325-793-3400
Mailing Address - Fax:325-793-3587
Practice Address - Street 1:4601 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4603
Practice Address - Country:US
Practice Address - Phone:325-793-3400
Practice Address - Fax:325-793-3587
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1321307OtherCOMMERCIAL INSURANCE
TX1321307Medicaid