Provider Demographics
NPI:1205804929
Name:THAYER, PATRICIA SOWDER (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SOWDER
Last Name:THAYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 GESSNER RD
Mailing Address - Street 2:SUITE 2150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2515
Mailing Address - Country:US
Mailing Address - Phone:713-935-9791
Mailing Address - Fax:713-935-0820
Practice Address - Street 1:929 GESSNER RD
Practice Address - Street 2:SUITE 2150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2515
Practice Address - Country:US
Practice Address - Phone:713-935-9791
Practice Address - Fax:713-935-0820
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6762207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B8482OtherBC/BS
TXG52274Medicare UPIN
TX8A7662Medicare ID - Type UnspecifiedMEDICARE