MEDICARE: DR. JEFFREY R THOMPSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0200X	Radiology Chiropractor	4035	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FTX101	OTHER	TX	MEDICARE GROUP

General Provider Information

NPI Number	:	1538201538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY R THOMPSON D.C.

Provider Business Mailing Address
First Line	:	2600 GESSNER DR
Second Line	:	STE 150
City	:	HOUSTON
State	:	TX
Zip	:	77080-3839
Country	:	US
Telephone Number	:	713-425-8100
Fax Number	:	713-425-8182

Provider Business Practice Location Address
First Line	:	2600 GESSNER DR
Second Line	:	STE 150
City	:	HOUSTON
State	:	TX
Zip	:	77080-3839
Country	:	US
Telephone Number	:	713-425-8100
Fax Number	:	713-425-8182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	11/28/2007

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Directions to “ DR. JEFFREY R THOMPSON D.C.” Practice Location

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