Individual
MR. CHARLES KELLEY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3551 ROGER BROOKE DR, MCHE-QD (CREDS), FORT SAM HOUSTON, TX 78234-4504
(210) 916-1766
Mailing address
3551 ROGER BROOKE DR, MCHE-QD (CREDS), FORT SAM HOUSTON, TX 78234-4504
(210) 916-1766
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA03696
TX
Other
Enumeration date
11/08/2005
Last updated
03/30/2015
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