Provider Demographics
NPI:1164154530
Name:THOMPSON, HALIE DENISE (BS)
Entity Type:Individual
Prefix:
First Name:HALIE
Middle Name:DENISE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 HIGHWAY 146 S APT 712
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77571-6163
Mailing Address - Country:US
Mailing Address - Phone:318-306-2283
Mailing Address - Fax:
Practice Address - Street 1:10025 MAIN ST STE C-4
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5209
Practice Address - Country:US
Practice Address - Phone:713-497-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator