Provider Demographics
NPI:1053040659
Name:GILMORE-THOMAS, ADRIENNE DORA (PHD)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DORA
Last Name:GILMORE-THOMAS
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 VINTAGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-3355
Mailing Address - Country:US
Mailing Address - Phone:832-329-5422
Mailing Address - Fax:
Practice Address - Street 1:16310 TOMBALL PKWY STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-1814
Practice Address - Country:US
Practice Address - Phone:210-864-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34435101YP2500X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional