Provider Demographics
NPI:1629489505
Name:THOMAS, GLENTY (NP)
Entity Type:Individual
Prefix:
First Name:GLENTY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:MSB 4.234
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-704-4718
Mailing Address - Fax:713-704-6850
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:SUITE 1400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-704-4718
Practice Address - Fax:713-704-6850
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2015-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY564235-1163WC0200X
NYF307023-1363LA2200X
TXAP126978363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine