Provider Demographics
NPI:1548234842
Name:THOMPSON, CHRISTOPHER P (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:P
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5929 BALCONES DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4280
Mailing Address - Country:US
Mailing Address - Phone:512-368-8715
Mailing Address - Fax:512-335-3382
Practice Address - Street 1:5929 BALCONES DR STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4280
Practice Address - Country:US
Practice Address - Phone:512-368-8715
Practice Address - Fax:512-233-5338
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2020-1060207Y00000X
CODR0048157207Y00000X
FLME142510207Y00000X
TXJ4559174400000X, 207Y00000X
AZ63345207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR0048157OtherSTATE LICENSE
FLME142796OtherSTATE LICENSE
85931NMedicare ID - Type Unspecified