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General NPI Number Information
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NPI Number | 1114657897
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Entity Type | Individual
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Provider Name | PAULA ANTOINETTE THOMAS
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 990 IH 10 N
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City | BEAUMONT
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State | TX
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Zip | 77702-1051
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Country | US
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Telephone | 832-484-9332
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Fax |
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Provider Business Mailing Address
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Address Line | 735 DULLES AVE APT 713
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City | STAFFORD
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State | TX
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Zip | 77477-5229
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Country | US
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Telephone | 832-484-9332
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 66103
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 66103
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License Number State | TX
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