Individual
KYLE DON THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
4407 AMBERLEY PL, COLLEGE STATION, TX 77845-2005
(979) 574-3674
Mailing address
4407 AMBERLEY PL, COLLEGE STATION, TX 77845-2005
(979) 574-3674
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1735
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049902498
BOARD OF CERTIFICATION
NE
01
—
AT1735
TEXAS DEPARTMENT OF LICENSURE AND REGULATION
TX
Enumeration date
12/16/2018
Last updated
12/16/2018
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