Provider Demographics
NPI:1306861448
Name:THOMPSON, JOYCE MAI (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MAI
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 1:5870 HIATUS RD
Mailing Address - Street 2:PE ADMIN-WEST REGION
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6424
Mailing Address - Country:US
Mailing Address - Phone:844-453-0046
Mailing Address - Fax:865-560-7089
Practice Address - Street 1:1000 WIGGINS PKWY
Practice Address - Street 2:CHRISTIAN CARE CENTER SR. LIVING COMMUNITY
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-7465
Practice Address - Country:US
Practice Address - Phone:972-686-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5017207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145509902Medicaid
TX8X0053OtherBCBS
TX045509901Medicaid
TX045509903Medicaid
TX80660SOtherBCBS
TX8AK729OtherBCBS
TX80660SOtherBCBS
TX87307FMedicare PIN
TX045509901Medicaid
TX045509903Medicaid
TXP00457801Medicare PIN
TX8AK729OtherBCBS
TX145509902Medicaid