Provider Demographics
NPI:1215380472
Name:THOMPSON, CHRIS RYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:RYAN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:RYAN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:418 SUNSET CIR
Mailing Address - Street 2:
Mailing Address - City:TIKI ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77554-7802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:ORAL AND MAXILLOFACIAL SURGERY
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:832-492-9205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32039122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist