MEDICARE: MATTHEW M THOMPSON MD

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	2084P0800X	Psychiatry Physician	K7220	TX

General Provider Information

NPI Number	:	1821178161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW M THOMPSON MD

Provider Business Mailing Address
First Line	:	909 FROSTWOOD DR
Second Line	:	SUITE 1.100
City	:	HOUSTON
State	:	TX
Zip	:	77024-2301
Country	:	US
Telephone Number	:	713-338-4523
Fax Number	:	713-338-5500

Provider Business Practice Location Address
First Line	:	2000 NORTH LOOP W
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77018-8124
Country	:	US
Telephone Number	:	713-812-7173
Fax Number	:	713-812-7163

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	02/03/2012

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