Provider Demographics
NPI:1194860338
Name:W. BRENT THOMPSON D.C., P.C.
Entity Type:Organization
Organization Name:W. BRENT THOMPSON D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-247-2295
Mailing Address - Street 1:2755 VALWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-3529
Mailing Address - Country:US
Mailing Address - Phone:972-247-2295
Mailing Address - Fax:
Practice Address - Street 1:2755 VALWOOD PKWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-3529
Practice Address - Country:US
Practice Address - Phone:972-247-2295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2412111N00000X
TX9613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1861495228OtherINDIVIDUAL NPI NUMBER
TX1639215296OtherINDIVIDUAL NPI NUMBER
TXY36898Medicare UPIN
TX1639215296OtherINDIVIDUAL NPI NUMBER
TX8G0488Medicare ID - Type UnspecifiedMEDICARE LEGACY
TX00055ZMedicare ID - Type UnspecifiedMEDICARE GROUP