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General NPI Number Information
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NPI Number | 1619989266
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Entity Type | Individual
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Provider Name | MATTHEW DAVID THOMPSON DO
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 2625 SCRIPTURE ST. SUITE 101
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City | DENTON
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State | TX
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Zip | 76201
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Country | US
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Telephone | 940-600-7425
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Fax | 972-539-3038
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Provider Business Mailing Address
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Address Line | PO BOX 270161
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City | FLOWER MOUND
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State | TX
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Zip | 75027-0161
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Country | US
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Telephone | 940-600-7425
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Fax | 972-539-3038
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M3405
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License Number State | TX
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