Individual
MRS. NICOLE IRENE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABOC
Contact information
Practice address
4719 CAMINO DORADO DR, SUITE 1, SAN ANTONIO, TX 78233-6302
(210) 354-7390
Mailing address
4719 CAMINO DORADO DR, SUITE 1, SAN ANTONIO, TX 78233-6302
(210) 354-7390
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146151
AMERICAN BOARD OF OPTICIANRY
TX
Enumeration date
01/03/2014
Last updated
09/09/2016
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