Provider Demographics
NPI:1891355764
Name:HEREDIA-THOMAS, DIONISE M
Entity type:Individual
Prefix:
First Name:DIONISE
Middle Name:M
Last Name:HEREDIA-THOMAS
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 1:17810 RUNNING BROOK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6142
Mailing Address - Country:US
Mailing Address - Phone:361-537-8463
Mailing Address - Fax:713-838-0926
Practice Address - Street 1:24624 INTERSTATE 45 N STE 200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4084
Practice Address - Country:US
Practice Address - Phone:832-680-3561
Practice Address - Fax:832-261-9945
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist