Provider Demographics
NPI:1427565282
Name:FRAZIER DBA ALPHA-1 HCS, THELMA LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:THELMA
Middle Name:LOUISE
Last Name:FRAZIER DBA ALPHA-1 HCS
Suffix:
Gender:F
Credentials:RN
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 750
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75456-0750
Mailing Address - Country:US
Mailing Address - Phone:903-575-8936
Mailing Address - Fax:903-717-8507
Practice Address - Street 1:315 N JOHNSON AVE STE 105
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-3951
Practice Address - Country:US
Practice Address - Phone:903-575-8936
Practice Address - Fax:903-305-2357
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX880561163W00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty