Healthcare Provider Details

I. General information

NPI: 1609167089
Provider Name (Legal Business Name): LAURA A THOMAS WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 GULF FWY
HOUSTON TX
77023-3548
US

IV. Provider business mailing address

4600 GULF FWY
HOUSTON TX
77023-3548
US

V. Phone/Fax

Practice location:
  • Phone: 713-522-3976
  • Fax: 404-494-7435
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number733876
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN131946
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP06390
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP118406
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: