Provider Demographics
NPI:1619488905
Name:THIELEMAN, CHLOE LEE (PA-C)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:LEE
Last Name:THIELEMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 2200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-6102
Mailing Address - Fax:713-790-2085
Practice Address - Street 1:6550 FANNIN ST STE 2200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-6102
Practice Address - Fax:713-790-2085
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059152363A00000X
CAPA56260363A00000X
TXPA17492363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant