Doctor Name: | MRS. DOROTHY MAE THOMPSON |
NPI Number: | 1033259155 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | PA04163 |
Business Practice Address: | 4310 Boots Dr Killeen, TX - 765492794 |
Business Phone Number: | 2545396101 |
Business Fax Number: | |
Mailing Address: | 4310 Boots Dr, KILLEEN |
State: | TX |
Postal Code: | 765492794 |
Phone Number: | 2545396101 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA04163 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |