Provider Demographics
NPI:1285864660
Name:DR ROBERT B THOMPSON AND ASSOCIATES
Entity type:Organization
Organization Name:DR ROBERT B THOMPSON AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:903-839-7337
Mailing Address - Street 1:1200 STATE HIGHWAY 110 N
Mailing Address - Street 2:STE E
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3058
Mailing Address - Country:US
Mailing Address - Phone:903-839-7337
Mailing Address - Fax:903-839-4148
Practice Address - Street 1:1200 STATE HIGHWAY 110 N
Practice Address - Street 2:STE E
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-3058
Practice Address - Country:US
Practice Address - Phone:903-839-7337
Practice Address - Fax:903-839-4148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9301174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD9301Medicaid
TXOOD91SMedicare UPIN