Individual
KELSEY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Mailing address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
1619
TX
224P00000X
Prosthetist
1619
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110686-01
—
TX
01
—
1276950002
MEDICARE PTAN
TX
Enumeration date
12/02/2014
Last updated
02/10/2016
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