Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Raven Thacker, NP

Individual provider Gerontology Nurse Practitioner · NPI 1003673559

Raven Thacker, NP is a Nurse Practitioner in Houston, Texas. Qualified in 2022, 4 years ago. Practices with Physicians Referral Service, a 2,727-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2024
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone: (713) 792-6161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 1136389 (TX)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 1136389 (TX)

Record details

NPI number1003673559
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 1, 2024
Last updated in NPPESApril 30, 2024
Certification dateApril 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Physicians Referral Service — 2727 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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