Provider Demographics
NPI:1235130493
Name:THOMPSON, TROY D (MD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:D
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 ROUND ROCK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4026
Mailing Address - Country:US
Mailing Address - Phone:512-341-2800
Mailing Address - Fax:512-341-2801
Practice Address - Street 1:2300 ROUND ROCK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4026
Practice Address - Country:US
Practice Address - Phone:512-341-2800
Practice Address - Fax:512-341-2801
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0948208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180655601Medicaid
I43006Medicare UPIN