Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | J4287 | TX |
NPI | 1023022340 |
---|---|
Provider Name | Dr. Melissa Lasola Tompkins |
First Address | Carrollton, TX 75011-7506 |
Second Address | Carrollton, TX 75010-4629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 03/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046333301 | (05) | TX |
8808J0 | BLUE CROSS BLUE SHIELD (01) | TX |
G65749 | (02) | TX |
P00275460 | RAILROAD MEDICARE (01) | TX |