Provider Demographics
NPI:1710388855
Name:THOMPSON, CARVIN JEAN II (ATC)
Entity Type:Individual
Prefix:MR
First Name:CARVIN
Middle Name:JEAN
Last Name:THOMPSON
Suffix:II
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 BELVOIR CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75233-4004
Mailing Address - Country:US
Mailing Address - Phone:214-675-3534
Mailing Address - Fax:
Practice Address - Street 1:3911 BELVOIR CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75233-4004
Practice Address - Country:US
Practice Address - Phone:214-675-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer