Provider Demographics
NPI:1619205978
Name:O. A. THOMPSON, D.D.S. INC
Entity Type:Organization
Organization Name:O. A. THOMPSON, D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-259-6502
Mailing Address - Street 1:308 N. O'CONNOR RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7524
Mailing Address - Country:US
Mailing Address - Phone:972-259-6502
Mailing Address - Fax:972-259-2598
Practice Address - Street 1:308 N. O'CONNOR RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7524
Practice Address - Country:US
Practice Address - Phone:972-259-6502
Practice Address - Fax:972-259-2598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:O. A. THOMPSON, D.D.S. INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
00E-217Medicare UPIN