Provider Demographics
NPI:1003494592
Name:THOMPSON, KEVIN PARKER (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:PARKER
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 S 31ST ST # 9C513C
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508-0001
Mailing Address - Country:US
Mailing Address - Phone:754-724-0108
Mailing Address - Fax:754-724-8067
Practice Address - Street 1:2401 S 31ST ST # 9C513C
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:754-724-0108
Practice Address - Fax:754-724-8067
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program