Healthcare Provider Details

I. General information

NPI: 1376368043
Provider Name (Legal Business Name): THRASHERS NEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 WAMPLER DR
THE COLONY TX
75056-1024
US

IV. Provider business mailing address

4629 CHAPMAN ST
THE COLONY TX
75056-3107
US

V. Phone/Fax

Practice location:
  • Phone: 469-379-7405
  • Fax:
Mailing address:
  • Phone: 469-379-7405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MELANIE REGINA THRASHER- IGORI
Title or Position: OWNER
Credential:
Phone: 469-379-7405