Provider Demographics
NPI:1245219385
Name:THOMPSON, LUISA M (OD)
Entity Type:Individual
Prefix:MRS
First Name:LUISA
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8089 CALLAGHAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4718
Mailing Address - Country:US
Mailing Address - Phone:210-342-1228
Mailing Address - Fax:210-342-6591
Practice Address - Street 1:8089 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4718
Practice Address - Country:US
Practice Address - Phone:210-342-1228
Practice Address - Fax:210-342-6591
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2329T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT16271Medicare UPIN
TX82036EMedicare PIN