Provider Demographics
NPI:1700386505
Name:THOMAS, VERONICA LENICE
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:LENICE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BROMPTON ST APT 5131
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2168
Mailing Address - Country:US
Mailing Address - Phone:706-513-2943
Mailing Address - Fax:
Practice Address - Street 1:6034 WILLOWBEND BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4731
Practice Address - Country:US
Practice Address - Phone:706-513-2943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302514164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse