Provider Demographics
NPI:1184051203
Name:THOMPSON, PHILIP (MBBS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 RICHMOND AVE
Mailing Address - Street 2:APARTMENT 504
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3259
Mailing Address - Country:US
Mailing Address - Phone:832-341-8022
Mailing Address - Fax:
Practice Address - Street 1:1400 PRESSLER ST
Practice Address - Street 2:FC.4.3000, DEPT. LEUKEMIA, MD ANDERSON CANCER CENTER
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3722
Practice Address - Country:US
Practice Address - Phone:713-792-7430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44956207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351019001Medicaid
TX434886YKQHMedicare PIN