Provider Demographics
NPI:1780452763
Name:MITCHELL, RHEA THIBODEAUX
Entity type:Individual
Prefix:
First Name:RHEA
Middle Name:THIBODEAUX
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RHEA
Other - Middle Name:KATHRYN
Other - Last Name:THIBODEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3827 WATERBEND CV
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1775
Mailing Address - Country:US
Mailing Address - Phone:281-728-0019
Mailing Address - Fax:
Practice Address - Street 1:7010 CHAMPIONS PLAZA DR STE 400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2395
Practice Address - Country:US
Practice Address - Phone:281-880-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX901369163W00000X
TX1152365367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse