Individual
RUSSEL L THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7400 BLANCO ROAD, SUITE 126, SAN ANTONIO, TX 78216-3500
(210) 699-8700
(210) 587-2454
Mailing address
6502 NURSERY DR. STE 100, VICTORIA, TX 77904
(361) 575-0611
(361) 579-6913
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
32230
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32230
TEXAS PSYCHOLOGIST LIC #
TX
Enumeration date
09/16/2006
Last updated
11/08/2022
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