Provider Demographics
NPI:1831120039
Name:MANN, THOMAS H (PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:MANN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 HARWIN DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1687
Mailing Address - Country:US
Mailing Address - Phone:713-771-1587
Mailing Address - Fax:713-484-5474
Practice Address - Street 1:10101 HARWIN DR
Practice Address - Street 2:SUITE 310
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1687
Practice Address - Country:US
Practice Address - Phone:713-771-1587
Practice Address - Fax:713-484-5474
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24687103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029440701Medicaid
TX029440701Medicaid
TX00040EMedicare ID - Type UnspecifiedTRAILBLAZER