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Individual

MR. SHAWN DALE THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.O.

Contact information

Practice address
6812 E HIGHWAY 67, ALVARADO, TX 76009-6857
(817) 783-2757
(866) 591-2741
Mailing address
6812 E HIGHWAY 67, ALVARADO, TX 76009-6857
(817) 783-2757
(866) 591-2741

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
189
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
189
ORTHOTIC LICENSE
TX
Enumeration date
03/27/2007
Last updated
12/20/2011
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