Provider Demographics
NPI:1730141144
Name:THORPE, BROOKE L (PT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:L
Last Name:THORPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:TROTTER-THORPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 60037
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-0037
Mailing Address - Country:US
Mailing Address - Phone:361-949-9898
Mailing Address - Fax:361-949-9897
Practice Address - Street 1:14302 NEMO COURT
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418
Practice Address - Country:US
Practice Address - Phone:361-949-9898
Practice Address - Fax:361-949-9897
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1118651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4282OtherBCBS
TX8D7030Medicare PIN