Healthcare Provider Details
I. General information
NPI: 1770773202
Provider Name (Legal Business Name): TMG MEDICAL GROUP, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2007
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1221 W BEN WHITE BLVD SUITE B-100
AUSTIN TX
78704-6888
US
IV. Provider business mailing address
8637 FREDERICKSBURG RD SUITE 360
SAN ANTONIO TX
78240-1283
US
V. Phone/Fax
- Phone: 512-442-1996
- Fax:
- Phone: 210-617-4735
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEORGE
M.
RAPIER
III
Title or Position: PRESIDENT
Credential: M.D.
Phone: 210-617-4735