Provider Demographics
NPI:1427814490
Name:THOMPSON, HOLLIN P (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:HOLLIN
Middle Name:P
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 COLLEGE DR APT 1004
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-7382
Mailing Address - Country:US
Mailing Address - Phone:936-671-3946
Mailing Address - Fax:
Practice Address - Street 1:1309 BROOKWOOD PL
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-4233
Practice Address - Country:US
Practice Address - Phone:936-671-3946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT91909133V00000X
133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered