Individual
AGNES THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6842 SHALLOW RIVER CT, SPRING, TX 77379-4193
(832) 704-7494
Mailing address
6842 SHALLOW RIVER CT, SPRING, TX 77379-4193
(832) 704-7494
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
18284941
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18284941
TEXAS DRIVERS LICENSE
TX
Enumeration date
08/13/2010
Last updated
08/13/2010
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