Individual
MS. ANNA THANNICKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2002 HOLCOMBE BLVD, HOUSTON, TX 77030-4211
(713) 791-1414
Mailing address
3926 INDIAN PT, MISSOURI CITY, TX 77459-6357
(917) 853-1597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
011022
NY
363A00000X
Physician Assistant
Primary
PA13466
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02825029
—
NY
Enumeration date
12/13/2006
Last updated
01/11/2022
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