HOLLY THIBODEAUX FNP-C NPI 1104028554

NPI Information

NPI: 1104028554
Provider Name: HOLLY THIBODEAUX, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
506 GRAHAM DR STE 200
TOMBALL, TX
ZIP 77375
Phone: (281) 255-3838
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Holly Thibodeaux, FNP-C is a family nurse practitioner in Tomball, TX with 18 years of experience. Holly Thibodeaux, FNP-C NPI is 1104028554. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

506 GRAHAM DR STE 200
TOMBALL, TX
ZIP 77375-346
Phone: (281) 255-3838
Fax: (281) 255-3788

The NPI 1104028554 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/5/2007 and was last updated on 1/19/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APO5164	LOUISIANA	No
2	363LF0000X	Nurse Practitioner	Family	125933	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	3A4917627	MEDICARE PIN	LOUISIANA
2	3A491	MEDICARE PIN	LOUISIANA
3	1028771	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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