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NPI Code Detail

MEDICARE: DR. TRACI K THOMPSON PHARM.D.

MEDICARE: DR. TRACI K THOMPSON PHARM.D.
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
11835P1200XPharmacotherapy Pharmacist43220TX
21835S0206XSolid Organ Transplant Pharmacist43220TX
3183500000XPharmacist43220TX

General Provider Information

NPI Number : 1396727061
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACI K THOMPSON PHARM.D.
Provider Business Mailing Address
First Line : 3506 21ST ST STE 201
Second Line :
City : LUBBOCK
State : TX
Zip : 79410-1211
Country : US
Telephone Number : 806-725-3800
Fax Number :
Provider Business Practice Location Address
First Line : 3615 19TH ST # 149
Second Line :
City : LUBBOCK
State : TX
Zip : 79410-1209
Country : US
Telephone Number : 806-725-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 08/06/2025

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