Provider Demographics
NPI:1720471808
Name:THOMASON, MOLLY MISHLER (PHD)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MISHLER
Last Name:THOMASON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:THERESA
Other - Last Name:MISHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15902 CREEK HILL LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3475
Mailing Address - Country:US
Mailing Address - Phone:847-208-1183
Mailing Address - Fax:
Practice Address - Street 1:707 S FRY RD STE 160
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2257
Practice Address - Country:US
Practice Address - Phone:281-371-6082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37600103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty