Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | N3346 | TX |
NPI | 1003021593 |
---|---|
Provider Name | Dr. Carla Jeanne Thompson |
First Address | Austin, TX 78735-8982 |
Second Address | Austin, TX 78738-6723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 07/10/2015 |