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Individual

MR. THOMAS GARY PRIBYL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.T.C.

Contact information

Practice address
3007 N BEN WILSON ST, VICTORIA, TX 77901-5731
(361) 485-4467
Mailing address
10586 US HIGHWAY 87 S, VICTORIA, TX 77905-5719
(512) 657-1795

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
003978
PA
2255A2300X
Athletic Trainer
Primary
1795
TX
2255A2300X
Athletic Trainer
36001657A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003978
STATE LICENSE
PA
01
1795
STATE LICENSE
TX
01
36001657A
INDIANA PROFESSIONAL LICENSING AGENCY, ATHLETIC TRAINERS BOARD
IN
Enumeration date
04/03/2006
Last updated
11/02/2011
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