Provider Demographics
NPI:1073179099
Name:REYNOLDS THOMPSON, CATRENA
Entity Type:Individual
Prefix:
First Name:CATRENA
Middle Name:
Last Name:REYNOLDS THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 CALWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-9423
Mailing Address - Country:US
Mailing Address - Phone:281-379-4082
Mailing Address - Fax:
Practice Address - Street 1:9403 CALWOOD CIR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-9423
Practice Address - Country:US
Practice Address - Phone:281-379-4082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX156441164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse