Provider Demographics
NPI:1508312703
Name:THOMPSON, AQUILINA K (FNP)
Entity Type:Individual
Prefix:
First Name:AQUILINA
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AQUILINA
Other - Middle Name:K
Other - Last Name:MAGARE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:18707 HARDY OAK BLVD
Practice Address - Street 2:SUITE 2322
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4791
Practice Address - Country:US
Practice Address - Phone:210-545-6972
Practice Address - Fax:210-545-1016
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131618363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX368870701Medicaid
TXP01819902OtherRAILROAD
TX368870701Medicaid