MEDICARE: THOMPSON UGOH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	1044623	TX
2	363LA2200X	Adult Health Nurse Practitioner	1044623	TX

General Provider Information

NPI Number	:	1053070284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMPSON UGOH

Provider Business Mailing Address
First Line	:	9304 FOREST LN STE S-100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9304 FOREST LN STE S-100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-6238
Country	:	US
Telephone Number	:	469-888-3328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2021
Last Update Date	:	02/05/2026

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Directions to “ THOMPSON UGOH ” Practice Location

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