Provider Demographics
NPI:1417122755
Name:THOMPSON, DEBRA A (RPH)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 E COLLINS BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2253
Mailing Address - Country:US
Mailing Address - Phone:800-225-5967
Mailing Address - Fax:909-799-4364
Practice Address - Street 1:909 E COLLINS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2253
Practice Address - Country:US
Practice Address - Phone:972-619-8210
Practice Address - Fax:972-619-8222
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist