=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558136630
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RHEMA THOMAS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2023
-----------------------------------------------------
Last Update Date | 07/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14962 BERGAMONT COLONY ST
-----------------------------------------------------
City | SPLENDORA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77372-5567
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-259-9123
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18401 TIMBER FOREST DR
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77346-2535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-852-0501
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------