Provider Demographics
NPI:1285184747
Name:THOMAS, KARIE ANN (PA)
Entity Type:Individual
Prefix:MRS
First Name:KARIE
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 422
Mailing Address - Street 2:
Mailing Address - City:PORT BOLIVAR
Mailing Address - State:TX
Mailing Address - Zip Code:77650-0422
Mailing Address - Country:US
Mailing Address - Phone:409-789-2003
Mailing Address - Fax:409-684-8775
Practice Address - Street 1:2660 GULF FWY S
Practice Address - Street 2:SUITE 3
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6820
Practice Address - Country:US
Practice Address - Phone:832-505-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-09
Last Update Date:2016-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09290363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant