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General NPI Number Information
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NPI Number | 1861439069
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Entity Type | Individual
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Provider Name | PEYTON THOMPSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 11416 RUNNEL RIDGE RD
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City | MANOR
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State | TX
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Zip | 78653-3874
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Country | US
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Telephone | 512-760-0666
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Fax | 866-265-1725
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Provider Business Mailing Address
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Address Line | 11416 RUNNEL RIDGE RD
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City | MANOR
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State | TX
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Zip | 78653-3874
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Country | US
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Telephone | 512-760-0666
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Fax | 866-265-1725
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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 | D9687
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D9687
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D9687
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License Number State | TX
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