Provider Demographics
NPI:1982349635
Name:THRIVE HOME INFUSION SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:THRIVE HOME INFUSION SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-788-4463
Mailing Address - Street 1:PO BOX 1463
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-1463
Mailing Address - Country:US
Mailing Address - Phone:832-788-4463
Mailing Address - Fax:
Practice Address - Street 1:813 E X ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-3727
Practice Address - Country:US
Practice Address - Phone:832-788-4463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care