Provider Demographics
NPI:1801615992
Name:THOMPSON, SHANELLE (DOULA)
Entity type:Individual
Prefix:
First Name:SHANELLE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16246 NEW FIELD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2831
Mailing Address - Country:US
Mailing Address - Phone:346-546-6982
Mailing Address - Fax:
Practice Address - Street 1:16246 NEW FIELD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2831
Practice Address - Country:US
Practice Address - Phone:346-546-6982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT20488172V00000X
TX374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty