Provider Demographics
NPI:1659614360
Name:THOMAS, NENA DANIELLE (LMT)
Entity Type:Individual
Prefix:MS
First Name:NENA
Middle Name:DANIELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7404 TOWN CENTER BLVD.
Mailing Address - Street 2:SUITE 716
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471
Mailing Address - Country:US
Mailing Address - Phone:832-363-1640
Mailing Address - Fax:
Practice Address - Street 1:7404 TOWN CENTER BLVD
Practice Address - Street 2:SUITE 716
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-6220
Practice Address - Country:US
Practice Address - Phone:832-363-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT110369225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist