Healthcare Provider Details

I. General information

NPI: 1538215751
Provider Name (Legal Business Name): FAMILY MEDICAL CENTER, P.A. OF BILOXI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 DIVISION ST SUITE B
BILOXI MS
39530-2906
US

IV. Provider business mailing address

1025 DIVISION ST SUITE B
BILOXI MS
39530-2906
US

V. Phone/Fax

Practice location:
  • Phone: 228-374-2800
  • Fax: 228-374-2801
Mailing address:
  • Phone: 228-374-2800
  • Fax: 228-374-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15594
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17719
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17719
License Number StateMS

VIII. Authorized Official

Name: DR. THOMAS TRIEU
Title or Position: PRESIDENT
Credential: D.O.
Phone: 228-374-2800