Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | S4573 | TX |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | S4573 | TX |
NPI | 1326465576 |
---|---|
Provider Name | Jason F Thompson |
First Address | Corpus Christi, TX 78411-2549 |
Second Address | Corpus Christi, TX 78411-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 06/08/2020 |