Provider Demographics
NPI:1679117741
Name:THERIOT, KASIA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KASIA
Middle Name:
Last Name:THERIOT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15810 BELMAR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7819
Mailing Address - Country:US
Mailing Address - Phone:850-699-5739
Mailing Address - Fax:
Practice Address - Street 1:12435 BEECHNUT ST STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3989
Practice Address - Country:US
Practice Address - Phone:832-804-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily