Healthcare Provider Details

I. General information

NPI: 1396729117
Provider Name (Legal Business Name): DANIEL MICHAEL THOMPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 08/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 N. DOWLEN RD
BEAUMONT TX
77706-7690
US

IV. Provider business mailing address

3460 N. DOWLEN RD
BEAUMONT TX
77706-7690
US

V. Phone/Fax

Practice location:
  • Phone: 409-838-0346
  • Fax: 409-839-3710
Mailing address:
  • Phone: 409-838-0346
  • Fax: 409-839-3710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberL0648
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: