Individual
MS. CHASARETH EDWONNE THOMPSON
Active
Individual
MS. CHASARETH EDWONNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA08203
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009516-07
MEDICAID/GRIMES COUNTY CHC
TX
01
—
1700973187
NPI/GRIMES COUNTY CHC
TX
01
—
1821185299
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
TX
01
—
45-1981
MEDICARE/GRIMES COUNTY CHC
TX
01
—
74-1715140
BRAZOS VALLEY COMMUNITY ACTION AGENCY, INC.
TX
Enumeration date
04/19/2013
Last updated
04/19/2013
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