MEDICARE: MS. GISELE M. THISSEN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1022075	TX
2	364SC1501X	Community Health/Public Health Clinical Nurse Specialist	21989	CA
3	363L00000X	Nurse Practitioner	21989	CA

General Provider Information

NPI Number	:	1780939066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GISELE M. THISSEN FNP

Provider Business Mailing Address
First Line	:	2300 WOODFOREST PKWY N STE 250-220
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-6501
Country	:	US
Telephone Number	:	713-338-9474
Fax Number	:	713-348-9474

Provider Business Practice Location Address
First Line	:	2300 WOODFOREST PKWY N STE 250-220
Second Line	:
City	:	MONTGOMERY
State	:	TX
Zip	:	77316-6501
Country	:	US
Telephone Number	:	713-338-9474
Fax Number	:	713-348-9474

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2012
Last Update Date	:	01/15/2026

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