Provider Demographics
NPI:1013274463
Name:MICAH, THALIA LAEL (LAC, LMT, MTI)
Entity type:Individual
Prefix:DR
First Name:THALIA
Middle Name:LAEL
Last Name:MICAH
Suffix:
Gender:F
Credentials:LAC, LMT, MTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9934 JONES RD STE D7
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4102
Mailing Address - Country:US
Mailing Address - Phone:832-832-1237
Mailing Address - Fax:832-344-3611
Practice Address - Street 1:9934 JONES RD STE D7
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4102
Practice Address - Country:US
Practice Address - Phone:832-363-5588
Practice Address - Fax:832-363-5588
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN564171100000X
171R00000X, 374J00000X, 261QP3300X, 171400000X, 174H00000X, 261QM1300X, 376J00000X, 261QP3300X
CO0002962171100000X
TXMT131572225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No171R00000XOther Service ProvidersInterpreter
No374J00000XNursing Service Related ProvidersDoula
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No376J00000XNursing Service Related ProvidersHomemaker