Healthcare Provider Details

I. General information

NPI: 1275851719
Provider Name (Legal Business Name): JUSTIN H. THOMPSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8390 LYNDON B JOHNSON FWY STE 500
DALLAS TX
75243-1188
US

IV. Provider business mailing address

8390 LYNDON B JOHNSON FWY STE 500
DALLAS TX
75243-1188
US

V. Phone/Fax

Practice location:
  • Phone: 469-214-5735
  • Fax: 512-237-7336
Mailing address:
  • Phone: 469-214-5735
  • Fax: 512-237-7336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberP3826
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberP3826
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: