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HOLLY THIBODEAUX FNP-C
NPI 1104028554
Nurse Practitioner - Family in Tomball, TX

Active since June 05, 2007PECOS Enrolled
24727 TOMBALL PARKWAY, SUITE 120, TOMBALL, TX 77375(281) 440-5300(281) 378-3850 Get Directions Write a Review

NPPES record last updated: January 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Holly Thibodeaux Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOLLY THIBODEAUX FNP-C (NPI 1104028554) is an individual family provider in Tomball, Texas, licensed in Texas (125933) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104028554
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameHOLLY THIBODEAUXCredential: FNP-C
Location Address24727 TOMBALL PARKWAY, SUITE 120Tomball, TX 77375
Mailing Address506 Graham Dr Ste 200Tomball, TX 77375-3346 · (281) 255-3838 · Fax (281) 255-3788
Phone(281) 440-5300
Fax(281) 378-3850
Sole ProprietorNo
Enumeration DateJune 5, 2007
Last NPPES UpdateJanuary 24, 2025
NPPES CertifiedJanuary 23, 2025
✔ NPI 1104028554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 125933
24727 TOMBALL PARKWAY, Tomball, TX 77375
Open in Google Maps ↗

Other Identifiers 1

Medicaid1028771LA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Holly Thibodeaux Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Holly Thibodeaux reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

David P Ellent PLLC
10 mi
Pulmonary Disease
2255 E MOSSY OAKS RD STE 500
Spring, TX 77389
  • Reassigned Medicare billing, Texas enrollment
  • 107 clinicians in this Medicare group
NPI 1245777440 (281) 440-5300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
64 services44 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77375 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALANNA L. CRAIG, M.D.P.A.
Anesthesiology
24727 TOMBALL PARKWAY
TOMBALL, TX 77375
Harris County (281) 580-9030
TOMBALL EXPRESS MEDICAL CENTER, LP
Clinic/Center (Emergency Care)
24727 TOMBALL PARKWAY, SUITE 120
TOMBALL, TX 77375
Harris County (281) 516-0911
DR. TOBY HAMILTON M.D.
Emergency Medicine
24727 TOMBALL PARKWAY, SUITE 120
TOMBALL, TX 77375
Harris County (281) 516-0911
ALANNA L. CRAIG M.D.
Anesthesiology
24727 TOMBALL PARKWAY
TOMBALL, TX 77375
Harris County (281) 580-9030
TOMBALL IMAGING, LLP
Radiology (Diagnostic Radiology)
24727 TOMBALL PARKWAY, SUITE 110
TOMBALL, TX 77375
Harris County (281) 516-0660
TOMBALL SURGERY CENTER, LP
Clinic/Center (Ambulatory Surgical)
24727 TOMBALL PARKWAY
TOMBALL, TX 77375
Harris County (281) 255-5300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holly Thibodeaux's NPI number?

The NPI number for Holly Thibodeaux is 1104028554. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Where is Holly Thibodeaux located?

Holly Thibodeaux practices at 24727 Tomball Parkway Suite 120, Tomball, TX 77375. The listed phone number is (281) 440-5300.

What is Holly Thibodeaux's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Holly Thibodeaux enrolled in Medicare?

Yes. Holly Thibodeaux is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Holly Thibodeaux's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Thibodeaux reassigns Medicare benefits to David P Ellent PLLC (Spring, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Holly Thibodeaux's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Holly Thibodeaux was last updated on January 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.