Provider Demographics
NPI:1790671337
Name:CONNIE L THOMASON PLLC
Entity type:Organization
Organization Name:CONNIE L THOMASON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:214-546-3008
Mailing Address - Street 1:3424 BRUNCHBERRY LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-3623
Mailing Address - Country:US
Mailing Address - Phone:214-546-3008
Mailing Address - Fax:
Practice Address - Street 1:3424 BRUNCHBERRY LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-3623
Practice Address - Country:US
Practice Address - Phone:214-546-3008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty