Provider Demographics
NPI:1831347772
Name:THOMAS, SHONTAI MCMILLIAN (MED CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHONTAI
Middle Name:MCMILLIAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MED CCC-SLP
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Mailing Address - Street 1:340 N SAM HOUSTON PKWY E
Mailing Address - Street 2:STE 246
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3305
Mailing Address - Country:US
Mailing Address - Phone:832-421-2527
Mailing Address - Fax:832-932-1629
Practice Address - Street 1:480 N SAM HOUSTON PKWY E STE 124
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3521
Practice Address - Country:US
Practice Address - Phone:832-421-2527
Practice Address - Fax:832-932-1629
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX102722235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist