Provider Demographics
NPI:1396119335
Name:THOMPSON, CHRISTOPHER PAUL (LAC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11651 JOLLYVILLE ROAD
Mailing Address - Street 2:#150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-470-2264
Mailing Address - Fax:
Practice Address - Street 1:11651 JOLLYVILLE ROAD
Practice Address - Street 2:#150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-470-2264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01446171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist