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General NPI Number Information
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NPI Number | 1063189421
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Entity Type | Organization
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Legal Business Name | MYRIAM B THIELE MD PLLC
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Dates
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Enumeration Date | 08/24/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 5517 LOUETTA RD STE D
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City | SPRING
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State | TX
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Zip | 77379-7877
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Country | US
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Telephone | 346-413-3532
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Fax | 281-297-8024
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Provider Business Mailing Address
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Address Line | 5517 LOUETTA RD STE D
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City | SPRING
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State | TX
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Zip | 77379-7877
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MYRIAM B THIELE
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Credential | MD
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Telephone | 346-413-3532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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