Provider Demographics
NPI:1538201538
Name:THOMPSON, JEFFREY R (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GESSNER DR
Mailing Address - Street 2:STE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3839
Mailing Address - Country:US
Mailing Address - Phone:713-425-8100
Mailing Address - Fax:713-425-8182
Practice Address - Street 1:2600 GESSNER DR
Practice Address - Street 2:STE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3839
Practice Address - Country:US
Practice Address - Phone:713-425-8100
Practice Address - Fax:713-425-8182
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4035111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTX101OtherMEDICARE GROUP
TX8D0810Medicare PIN
TXT79117Medicare UPIN