Provider Demographics
NPI:1255329694
Name:THOMPSON, KATHERINE H (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:H
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 WEST LOOP S STE 620
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2417
Mailing Address - Country:US
Mailing Address - Phone:713-898-2958
Mailing Address - Fax:
Practice Address - Street 1:5909 WEST LOOP S STE 620
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2417
Practice Address - Country:US
Practice Address - Phone:713-984-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1699207QA0401X, 2080P0006X, 208VP0000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX058886501Medicaid
TX058886505Medicaid
TX058886504Medicaid
TX058886503Medicaid
TX020788801Medicaid
TX020788802Medicaid
TX8F24231Medicare PIN
TX058886505Medicaid
TX020788802Medicaid