Provider Demographics
NPI:1619414877
Name:THOLEN, ANN CHRISTINE (RDLD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:CHRISTINE
Last Name:THOLEN
Suffix:
Gender:F
Credentials:RDLD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:CHRISTINE
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDLD
Mailing Address - Street 1:6624 FANNIN ST STE 2260
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2334
Mailing Address - Country:US
Mailing Address - Phone:713-795-0770
Mailing Address - Fax:713-795-0855
Practice Address - Street 1:6624 FANNIN ST STE 2260
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2334
Practice Address - Country:US
Practice Address - Phone:713-795-0770
Practice Address - Fax:713-795-0855
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84605133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered