HOLLY THIBODEAUX FNP-C NPI 1104028554

NPI Information

  • NPI: 1104028554
  • Provider Name: HOLLY THIBODEAUX, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 24727 TOMBALL PARKWAY
    SUITE 120
    TOMBALL, TX
    ZIP 77375
  • Phone: (281) 440-5300

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NPI Details

Holly Thibodeaux, FNP-C is a family nurse practitioner in Tomball, TX. Holly Thibodeaux, FNP-C NPI is 1104028554. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

24727 TOMBALL PARKWAY
SUITE 120
TOMBALL, TX
ZIP 77375
Phone: (281) 440-5300
Fax: (281) 378-3850

The NPI 1104028554 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Annual depression screening, 15 minutes (HCPCS:G0444)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 6/5/2007 and was last updated on 1/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily125933TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11028771MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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