Provider Demographics
NPI:1639133267
Name:THIBODEAUX, CHRISTINA HOPE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:HOPE
Last Name:THIBODEAUX
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5509 PLEASANT VALLEY DR
Mailing Address - Street 2:SUITE 60
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5248
Mailing Address - Country:US
Mailing Address - Phone:972-985-9003
Mailing Address - Fax:972-985-1176
Practice Address - Street 1:5509 PLEASANT VALLEY DR
Practice Address - Street 2:SUITE 60
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5248
Practice Address - Country:US
Practice Address - Phone:972-985-9003
Practice Address - Fax:972-985-1176
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical