Provider Demographics
NPI:1689482770
Name:THEIN, PAW EH
Entity type:Individual
Prefix:
First Name:PAW
Middle Name:EH
Last Name:THEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 ROSE TRELLIS ST
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3751
Mailing Address - Country:US
Mailing Address - Phone:832-798-2514
Mailing Address - Fax:
Practice Address - Street 1:5319 ROSE TRELLIS ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3751
Practice Address - Country:US
Practice Address - Phone:832-798-2514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-21
Last Update Date:2024-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician