Provider Demographics
NPI:1891988416
Name:DR. JUDITH THOMPSON MD PA
Entity Type:Organization
Organization Name:DR. JUDITH THOMPSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-624-7993
Mailing Address - Street 1:876 LOOP 337
Mailing Address - Street 2:BLDG 101
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3518
Mailing Address - Country:US
Mailing Address - Phone:830-624-7993
Mailing Address - Fax:830-643-0737
Practice Address - Street 1:876 LOOP 337
Practice Address - Street 2:BLDG 101
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3518
Practice Address - Country:US
Practice Address - Phone:830-624-7993
Practice Address - Fax:830-643-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1098208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG30788Medicare UPIN