Individual provider · NPI-1

Thomas Daniel Brabham, PT, DPT

Physical Therapist · Conroe, TX

NPI number1245984111
StatusActive
Last updated in NPPESFeb 9, 2022

Details

NPI
1245984111
Entity type
Individual (NPI-1)
Name
Thomas Daniel Brabham
Credential
PT, DPT
Sex
Male
Sole proprietor
No
Enumeration date
Feb 9, 2022
Certification date
Feb 8, 2022
Last updated
Feb 9, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist1357922TXYes

Practice location

1803 W White Oak Ter Ste C
Conroe, TX 77304-3675

Phone 936-494-1211

Mailing address

780 Sawdust Rd Apt 231
Spring, TX 77380-4152

Phone 254-297-9986

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