Provider Demographics
NPI:1275998593
Name:THOMPSON, SUZANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 NW AVENUE I
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:TX
Mailing Address - Zip Code:79360-2511
Mailing Address - Country:US
Mailing Address - Phone:432-209-0477
Mailing Address - Fax:
Practice Address - Street 1:4425 19TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407
Practice Address - Country:US
Practice Address - Phone:806-788-2015
Practice Address - Fax:806-788-2016
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist