=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366553935
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAUREE LYNELL THOMPSON M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 08/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2830 CALDER ST NICU
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77702-1809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-899-7890
-----------------------------------------------------
Fax | 409-899-7363
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5130
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77726-5130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-351-2278
-----------------------------------------------------
Fax | 409-899-7363
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080N0001X
-----------------------------------------------------
Taxonomy Name | Neonatal-Perinatal Medicine Physician
-----------------------------------------------------
License Number | L0649
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------