Individual
KATHRYN JO THOMPSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
702 E MIMOSA ST, ROCKPORT, TX 78382-4151
(361) 729-0652
(361) 729-9508
Mailing address
PO BOX 2255, ROCKPORT, TX 78381-2255
(361) 729-0652
(361) 729-9508
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
100825
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
659640
BCBS
TX
Enumeration date
11/21/2005
Last updated
07/09/2007
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