Provider Demographics
NPI:1083171904
Name:THOMPSON, RACHEL MARIE (LM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 BOULDER CT
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4505
Mailing Address - Country:US
Mailing Address - Phone:858-371-8413
Mailing Address - Fax:
Practice Address - Street 1:309 BOULDER CT
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-4505
Practice Address - Country:US
Practice Address - Phone:858-371-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99362176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife