Basic Information
| Provider Information | |||||||||
| NPI: | 1306861448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMPSON | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | MAI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5870 HIATUS RD | ||||||||
| Address2: | PE ADMIN-WEST REGION | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333216424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8444530046 | ||||||||
| FaxNumber: | 8655607089 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 WIGGINS PKWY | ||||||||
| Address2: | CHRISTIAN CARE CENTER SR. LIVING COMMUNITY | ||||||||
| City: | MESQUITE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751507465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726862400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 10/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | K5017 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | K5017 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 145509902 | 05 | TX | MEDICAID | 8X0053 | 01 | TX | BCBS | OTHER | 045509901 | 05 | TX | MEDICAID | 045509903 | 05 | TX | MEDICAID | 80660S | 01 | TX | BCBS | OTHER | 8AK729 | 01 | TX | BCBS | OTHER |