Healthcare Provider Details

I. General information

NPI: 1508770397
Provider Name (Legal Business Name): BIBIL DEENA THOMAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 EBERHART STAR CT
KATY TX
77494-2519
US

IV. Provider business mailing address

1607 EBERHART STAR CT
KATY TX
77494-2519
US

V. Phone/Fax

Practice location:
  • Phone: 346-291-0287
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1142938
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1142938
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1142938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: