Individual
ANMONA THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19722 SAUMS RD, HOUSTON, TX 77084-4734
(281) 600-0786
(281) 600-7786
Mailing address
19722 SAUMS RD, HOUSTON, TX 77084-4734
(281) 600-0786
(281) 600-7786
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
—
—
208000000X
Pediatrics Physician
C1-0009783
DE
208000000X
Pediatrics Physician
Primary
P7218
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006-01358
STATE LICENSE
NC
01
—
C1-0009783
PROFESSIONAL LICENSE
DE
Enumeration date
11/01/2006
Last updated
02/24/2016
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