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General NPI Number Information
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NPI Number | 1205612496
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Entity Type | Individual
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Provider Name | TRISTAN SHARROD THOMPSON MPH
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Gender | Male
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 6009 W PARKER RD STE 149-238
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City | PLANO
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State | TX
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Zip | 75093-8120
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Country | US
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Telephone | 281-884-2975
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Fax |
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Provider Business Mailing Address
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Address Line | 6009 WEST PARKER RD STE 149 PMB 238
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 282-884-2975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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