Individual
KELLY CATES THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20503 NEWFALLS CT, RICHMOND, TX 77407-7856
(713) 213-7370
Mailing address
20503 NEWFALLS CT, RICHMOND, TX 77407-7856
(713) 213-7370
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
161705
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161705
—
TX
Enumeration date
09/03/2018
Last updated
09/03/2018
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