Provider Demographics
NPI:1083048227
Name:THOMAS, LAURA MATTHEWS (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MATTHEWS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:281-240-0030
Practice Address - Street 1:915 GESSNER RD STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-461-2626
Practice Address - Fax:713-987-1703
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200656363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2343785Medicaid