Provider Demographics
NPI:1023425410
Name:THOMPSON, OLGA MARIA (LAT)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:MARIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:MARIA
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAT
Mailing Address - Street 1:1317 W JONQUIL AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3806
Mailing Address - Country:US
Mailing Address - Phone:512-636-8350
Mailing Address - Fax:
Practice Address - Street 1:3100 GULL AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5093
Practice Address - Country:US
Practice Address - Phone:956-580-5189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT08582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer