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Organization
THOMPSON OUTPATIENT CLINIC, LLC
Active
Organization
THOMPSON OUTPATIENT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY LEE THOMPSON PA (OWNER)
(409) 296-2910
Entity
Organization
Contact information
Practice address
304 BROADWAY, WINNIE, TX 77665-7829
(409) 296-2910
(409) 296-3003
Mailing address
PO BOX 714, WINNIE, TX 77665-0714
(409) 296-2910
(409) 296-3003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038MQ
BCBS GROUP NUMBER
TX
05
—
171711802
—
TX
05
—
171711803
—
TX
01
—
DC8996
MEDICARE RRW GROUP NUMBER
TX
Enumeration date
08/21/2006
Last updated
04/11/2022
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