HOLLY THIBODEAUX (NPI# 1104028554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104028554 |
| Entity Type | Individual |
| Full Name | HOLLY THIBODEAUX |
| Credential | FNP-C |
| Practice Address |
506 Graham Dr Ste 200 Tomball TX 77375-3346 |
| Practice Telephone | 2812553838 |
| Practice Fax Number | 2812553788 |
| Mailing Telephone | 2812553838 |
| Mailing Fax Number | 2812553788 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2015-01-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
125933 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APO5164 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1028771 | 05 |
| Street Address |
506 GRAHAM DR STE 200 |
| City | TOMBALL |
| State | TX |
| Zip Code | 77375-3346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215543467 | Carson Craig Doty | Physician Assistant | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2020-09-22 |
| 1407460686 | Courtney Rae Martinez | Nurse Practitioner | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2020-09-03 |
| 1174137475 | Morgan Brittany Musgrove | Nurse Practitioner | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2020-09-03 |
| 1962973883 | Hailey Elizabeth Hicks | Nurse Practitioner | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2018-12-17 |
| 1700313970 | Leah Lopez | Nurse Practitioner | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2017-05-17 |
| 1376089318 | Kimberly Schlett | Nurse Practitioner | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2017-01-15 |
| 1407115009 | Trisha Roberts Coover | Nurse Practitioner | 506 Graham Dr Ste 200, Tomball, TX 77375-3346 | 2012-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063997997 | Michael Jahn | Counselor | 103 Tadpole Court, Woodlands, TX 77375 | 2018-09-26 |
| 1467943266 | Willow Creek Smiles Pllc | Clinic/Center | 9166 Farm To Market 2920 Rd, Suite 900, Tomball, TX 77375 | 2018-05-29 |
| 1962991315 | Betty Harbour | Technician | 10 Capri Bend, Tom Ball, TX 77375 | 2018-05-01 |
| 1336652353 | Juanita Dolores Paras | Occupational Therapy Assistant | 19203 Carriage Vale Ln, Tomball, TX 77375 | 2017-11-13 |
| 1215446885 | Ideal Dental of Augusta Pines Pllc | Dentist | 25760 Kuykendahl, Suite A, Tomball, TX 77375 | 2017-09-26 |
| 1285151936 | Cagney Reeves | Pharmacist | 28520 Tobmall Parkway, Tomball, TX 77375 | 2017-08-24 |
| 1710411616 | Perseverance Heatlh Innovation Ltd | Contractor | 21706 Willow Downs, Tomball, TX 77375 | 2017-04-18 |
| 1972042158 | Rite Choice Healthcare, Pllc | Dentist | 27030 Tomball Pkwy, Tomball, TX 77375 | 2017-02-21 |
| 1306398029 | Pharmcare Usa of Houston LLC | Pharmacy | 420 Chestnut Business Park Dr., Suite C, Tomball, TX 77375 | 2016-10-28 |
| 1992256325 | Wal-mart Stores Texas, LLC | Technician/Technologist | 25800 Kuykendahl Road, Tomball, TX 77375 | 2016-10-20 |
| Find all providers in zip 77375 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386291912 | Alyse Mullon Tumelson | Nurse Practitioner | 26 Satinleaf Pl, Tomball, TX 77375-7206 | 2019-08-19 |
| 1598235046 | Nousheen Maredia Nayani | Nurse Practitioner | 25411 Hollowgate Park Ln, Tomball, TX 77375-1494 | 2018-11-27 |
| 1942796784 | Alyssa Lewis | Nurse Practitioner | 18611 Summercliff Ln, Tomball, TX 77377-7579 | 2018-07-05 |
| 1972097491 | Latrisala Bankston | Nurse Practitioner | 15535 Downford Dr, Tomball, TX 77377 | 2018-06-18 |
| 1720599558 | Shirley Morris | Nurse Practitioner | 24507 Emerald Pool Falls Dr, Tomball, TX 77375-5367 | 2017-10-19 |
| 1245740893 | Rachel Jones | Nurse Practitioner | 455 School St Ste 44, Tomball, TX 77375-4688 | 2017-10-10 |
| 1447614334 | Lori Walkoviak | Nurse Practitioner | 22611 Torrisdale Ln, Tomball, TX 77375-2071 | 2016-04-07 |
| 1780817163 | Maria Elena Alvarez | Nurse Practitioner | 26288 Kuykendahl Rd, Tomball, TX 77375-2657 | 2009-09-01 |
| 1043339336 | Dollie Ann Husfeld | Nurse Practitioner | 425 Holderrieth Blvd Ste 112, Tomball, TX 77375-4551 | 2007-03-28 |
| 1336264894 | Patricia Joanne Matlock | Nurse Practitioner | 425 Holderrieth, Blvd, Tomball, TX 77375 | 2007-03-20 |
| Find all providers in TOMBALL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.