Individual
KEN LEE THRASHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 VISTA RD BLDG A, PASADENA, TX 77504-2117
(713) 378-3066
(713) 378-3077
Mailing address
PO BOX 5607, PASADENA, TX 77508-5607
(713) 378-3066
(713) 378-3077
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J7290
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046CC
MEDICARE RPK GROUP #
TX
05
—
040147301
—
TX
01
—
82184F
BC/BS
TX
Enumeration date
07/03/2006
Last updated
06/01/2009
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