Provider Demographics
NPI:1962620922
Name:TREY THOMPSON, DDS, PA
Entity type:Organization
Organization Name:TREY THOMPSON, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:DURWARD
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-493-5480
Mailing Address - Street 1:909 DAIRY ASHFORD ST STE 109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5306
Mailing Address - Country:US
Mailing Address - Phone:281-493-5480
Mailing Address - Fax:281-493-1473
Practice Address - Street 1:909 DAIRY ASHFORD ST STE 109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5306
Practice Address - Country:US
Practice Address - Phone:281-493-5480
Practice Address - Fax:281-493-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty