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NPI 1992865919

NPI 1992865919 : MICHAEL J THOMAS LCSW : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1992865919
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL J THOMAS LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    4615 SOUTHWEST FREEWAY SUITE 430
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77027
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    Country              |    US
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    Telephone            |    713-623-2984
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    Fax                  |    713-623-0067
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Provider Business Mailing Address
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    Address Line         |    4615 SOUTHWEST FREEWAY SUITE 430
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77027
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    Country              |    US
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    Telephone            |    713-623-2984
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    Fax                  |    713-623-0067
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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       |    01476
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    License Number State |    TX
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