Provider Demographics
NPI:1740612209
Name:THOMAS, JENNIFER M (MS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12605 EAST FWY
Mailing Address - Street 2:STE. 212
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5625
Mailing Address - Country:US
Mailing Address - Phone:713-453-0400
Mailing Address - Fax:713-453-0408
Practice Address - Street 1:12605 EAST FWY
Practice Address - Street 2:STE. 212
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5625
Practice Address - Country:US
Practice Address - Phone:713-453-0400
Practice Address - Fax:713-453-0408
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist