Provider Demographics
NPI:1558833640
Name:THIGPEN, SHARON MONIQUE
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MONIQUE
Last Name:THIGPEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20522 WINDSOR TRACE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-6487
Mailing Address - Country:US
Mailing Address - Phone:281-633-9770
Mailing Address - Fax:
Practice Address - Street 1:20522 WINDSOR TRACE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-6487
Practice Address - Country:US
Practice Address - Phone:281-633-9770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist