Provider Demographics
NPI:1003182130
Name:THOMPSON, KATHRYN L (PA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-4300
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:214-826-9792
Practice Address - Street 1:4101 JAMES CASEY ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1145
Practice Address - Country:US
Practice Address - Phone:512-447-2202
Practice Address - Fax:512-447-5337
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15924363A00000X
CAPA21927363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical