Individual provider Active NPI

Bruce L. Thompson, RPH

  • Pharmacist
  • Lake Worth, TX
National Provider Identifier
1063511566
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20832 Issued in TX
Practice address
6708 Lake Worth Blvd
Lake Worth, TX 76135-2902
Phone
(817) 237-7580
Fax
(817) 237-7581
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20832 TX Primary

Addresses

Primary practice location

6708 Lake Worth Blvd
Lake Worth, TX 76135-2902

Mailing address

5209 Garrick Ave
Fort Worth, TX 76133-2138
Phone (817) 294-1750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
20832TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookshire Grocery Company Past Accepting new patients
Brookshire Grocery Company Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063511566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 GARRICK AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332138",
            "telephone_number": "817-294-1750",
            "fax_number": "817-294-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6708 LAKE WORTH BLVD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352902",
            "telephone_number": "817-237-7580",
            "fax_number": "817-237-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRUCE",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "20832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.