Provider Demographics
NPI:1407533946
Name:THOMAS, ASHA (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31014 PECAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-2672
Mailing Address - Country:US
Mailing Address - Phone:215-779-8299
Mailing Address - Fax:
Practice Address - Street 1:6903 BRISBANE CT STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6845
Practice Address - Country:US
Practice Address - Phone:832-886-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126175363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care