Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | P3826 | TX |
NPI | 1275851719 |
---|---|
Provider Name | Justin H. Thompson |
First Address | Dallas, TX 75203 |
Second Address | Dallas, TX 75203-1586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2010 |
Last Update Date | 08/09/2017 |