Individual
MARK THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6312 AZLE AVE, LAKE WORTH, TX 76135-2442
(817) 238-8400
(817) 238-8401
Mailing address
6312 AZLE AVE, LAKE WORTH, TX 76135-2442
(817) 238-8400
(817) 238-8401
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2394
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
2398
TX
390200000X
Student in an Organized Health Care Education/Training Program
SC006749
PA
Other
Enumeration date
07/11/2016
Last updated
02/08/2023
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