Provider Demographics
NPI:1689003493
Name:THOMPSON, EVELYN (NP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:T
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:24431 AVANTI DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4279
Mailing Address - Country:US
Mailing Address - Phone:832-744-9779
Mailing Address - Fax:
Practice Address - Street 1:10318 LAKE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1874
Practice Address - Country:US
Practice Address - Phone:832-744-9779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-03
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X
TX1041043363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based