Provider Demographics
NPI:1164969291
Name:PATRICIA J. THOMAS, M.A., CCC, PLLC
Entity Type:Organization
Organization Name:PATRICIA J. THOMAS, M.A., CCC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:BAA,CPC,CRCM
Authorized Official - Phone:832-212-7547
Mailing Address - Street 1:505 N SAM HOUSTON PKWY E
Mailing Address - Street 2:S250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-4018
Mailing Address - Country:US
Mailing Address - Phone:713-828-2804
Mailing Address - Fax:
Practice Address - Street 1:505 N SAM HOUSTON PKWY E
Practice Address - Street 2:S250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4018
Practice Address - Country:US
Practice Address - Phone:713-828-2804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRICIA J. THOMAS, M.A., CCC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005432202Medicaid