Provider Demographics
NPI:1619196854
Name:THOMPSON, MICHAEL NEAL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NEAL
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 121271
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-1271
Mailing Address - Country:US
Mailing Address - Phone:817-501-4630
Mailing Address - Fax:425-660-6403
Practice Address - Street 1:2214 HEMPHILL ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-2014
Practice Address - Country:US
Practice Address - Phone:817-927-8482
Practice Address - Fax:817-927-8506
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor