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NPI Code Detail

MEDICARE: TMC PROVIDER GROUP, PLLC

MEDICARE: TMC PROVIDER GROUP, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/CenterF0031TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11053784660OTHERTXURGENT CARE

General Provider Information

NPI Number : 1306325618
Entity Type Code : Organization
Provider Name (Legal Business Name) : TMC PROVIDER GROUP, PLLC
Provider Business Mailing Address
First Line : PO BOX 4165
Second Line :
City : PORTLAND
State : OR
Zip : 97208-4165
Country : US
Telephone Number : 210-349-5577
Fax Number :
Provider Business Practice Location Address
First Line : 426 SINGING OAKS
Second Line :
City : SPRING BRANCH
State : TX
Zip : 78070-6508
Country : US
Telephone Number : 830-632-5740
Fax Number : 830-632-5743
Authorized Official
Title or Position : PRESIDENT
Name : ERICA HAUSER
Credential :
Telephone Number : 312-590-5372
Provider Enumeration Date : 08/08/2018
Last Update Date : 03/21/2023

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Directions to “TMC PROVIDER GROUP, PLLC ” Practice Location

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