Provider Demographics
NPI:1558458935
Name:THE THOMPSON CENTER FOR PLASTIC SURGERY
Entity Type:Organization
Organization Name:THE THOMPSON CENTER FOR PLASTIC SURGERY
Other - Org Name:THE THOMPSON CENTER FOR PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-341-2800
Mailing Address - Street 1:2300 ROUND ROCK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4026
Mailing Address - Country:US
Mailing Address - Phone:512-341-2800
Mailing Address - Fax:512-341-2801
Practice Address - Street 1:2300 ROUND ROCK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4026
Practice Address - Country:US
Practice Address - Phone:512-341-2800
Practice Address - Fax:512-341-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180653101Medicaid
TX00530ZMedicare ID - Type Unspecified
TX180653101Medicaid