Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | H8862 | TX |
Y | 208600000X | Surgeon | H8862 | TX |
NPI | 1003801119 |
---|---|
Provider Name | Dr. Robert Pool Thompson JR. |
First Address | Kyle, TX 78640-6319 |
Second Address | Kyle, TX 78640-6319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 14/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
097087302 | (05) | TX |
097087304 | (05) | TX |
097087305 | (05) | TX |
E88167 | (02) | TX |