MEDICARE: CHAD THOMPSON

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	164X00000X	Licensed Vocational Nurse	337708	TX

General Provider Information

NPI Number	:	1093283756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD THOMPSON

Provider Business Mailing Address
First Line	:	1003 NORTHGATE SPRINGS DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-5668
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 NORTHGATE SPRINGS DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-5668
Country	:	US
Telephone Number	:	713-201-9862
Fax Number	:

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

Provider Enumeration Date	:	11/10/2018
Last Update Date	:	11/10/2018

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Directions to “ CHAD THOMPSON ” Practice Location

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