Healthcare Provider Details

I. General information

NPI: 1336237387
Provider Name (Legal Business Name): MS. BEENA M THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N TEXAS AVE SUITE 4300
WEBSTER TX
77598-4966
US

IV. Provider business mailing address

P.O. BOX 4346 DEPT 494
HOUSTON TX
77210-4346
US

V. Phone/Fax

Practice location:
  • Phone: 281-338-5437
  • Fax: 281-338-9543
Mailing address:
  • Phone: 281-646-1935
  • Fax: 281-646-0927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK9434
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: