Provider Demographics
NPI:1326710799
Name:MAYRA JIMENEZ THOMPSON, MD PLLC
Entity Type:Organization
Organization Name:MAYRA JIMENEZ THOMPSON, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:JIMENEZ
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-528-5590
Mailing Address - Street 1:12200 PARK CENTRAL DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2120
Mailing Address - Country:US
Mailing Address - Phone:972-528-5590
Mailing Address - Fax:972-566-8461
Practice Address - Street 1:12200 PARK CENTRAL DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2120
Practice Address - Country:US
Practice Address - Phone:972-528-5590
Practice Address - Fax:972-566-8461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty