Provider Demographics
NPI:1346833068
Name:THOMPSON, CASTURAL DALE II (PA)
Entity Type:Individual
Prefix:MR
First Name:CASTURAL
Middle Name:DALE
Last Name:THOMPSON
Suffix:II
Gender:M
Credentials:PA
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Mailing Address - Street 1:8601 ANDERSON MILL RD APT 734
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4719
Mailing Address - Country:US
Mailing Address - Phone:512-569-1188
Mailing Address - Fax:
Practice Address - Street 1:1434 E SONTERRA BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4971
Practice Address - Country:US
Practice Address - Phone:210-402-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty