Provider Demographics
NPI:1346211083
Name:THOMPSON, ROBERT LEON JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEON
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 682614
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268-2614
Mailing Address - Country:US
Mailing Address - Phone:832-729-2869
Mailing Address - Fax:281-580-4984
Practice Address - Street 1:9725 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016-4403
Practice Address - Country:US
Practice Address - Phone:832-729-2869
Practice Address - Fax:281-580-4984
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6671207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH55457Medicare UPIN