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General NPI Number Information
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NPI Number | 1629816376
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Entity Type | Organization
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Legal Business Name | CREATED TO THRIVE PLLC
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 6922 W RAYFORD RD STE 200
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City | SPRING
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State | TX
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Zip | 77389-3004
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Country | US
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Telephone | 832-257-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 6922 W RAYFORD RD STE 200
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City | SPRING
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State | TX
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Zip | 77389-3004
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Country | US
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Telephone | 832-257-1100
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Fax | 833-973-3552
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CANDICE ALLEN
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Credential | MD
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Telephone | 832-257-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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