Provider Demographics
NPI:1588824809
Name:THACKREY, CATHY MAY (AUD, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:MAY
Last Name:THACKREY
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 22ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1147
Mailing Address - Country:US
Mailing Address - Phone:806-791-0188
Mailing Address - Fax:806-788-0470
Practice Address - Street 1:3802 22ND ST STE 200
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1147
Practice Address - Country:US
Practice Address - Phone:806-791-0188
Practice Address - Fax:806-788-0470
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51766237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter