Provider Demographics
NPI:1396446688
Name:THOMPSON, SYDNEY MICHELLE (OD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:MICHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:1500 COMMONS CIR STE 200
Practice Address - Street 2:
Practice Address - City:NORTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76226-2717
Practice Address - Country:US
Practice Address - Phone:940-382-2020
Practice Address - Fax:940-467-0156
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX10646T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist