Provider Demographics
NPI:1568905446
Name:THOMPSON, PULCHARIA (FNP)
Entity Type:Individual
Prefix:
First Name:PULCHARIA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PULCHARIA
Other - Middle Name:OKERE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:4781 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4723
Mailing Address - Country:US
Mailing Address - Phone:281-404-5490
Mailing Address - Fax:281-404-5494
Practice Address - Street 1:4781 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4723
Practice Address - Country:US
Practice Address - Phone:281-404-5490
Practice Address - Fax:281-404-5494
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132690363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily