Provider Demographics
NPI:1891822136
Name:JAMES B THOMPSON MD PA
Entity Type:Organization
Organization Name:JAMES B THOMPSON MD PA
Other - Org Name:GEORGETOWN FAMILY HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-763-3220
Mailing Address - Street 1:105 WILDWOOD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-1343
Mailing Address - Country:US
Mailing Address - Phone:512-763-3220
Mailing Address - Fax:512-763-3221
Practice Address - Street 1:105 WILDWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-1343
Practice Address - Country:US
Practice Address - Phone:512-763-3220
Practice Address - Fax:512-763-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E93584Medicare UPIN