Provider Demographics
NPI:1598041220
Name:THOOMPUMKAL, JIM JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:JIM
Middle Name:JOSEPH
Last Name:THOOMPUMKAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 N BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-4016
Mailing Address - Country:US
Mailing Address - Phone:469-417-0358
Mailing Address - Fax:
Practice Address - Street 1:1330 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4016
Practice Address - Country:US
Practice Address - Phone:469-417-0358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist