Healthcare Provider Details

I. General information

NPI: 1821685496
Provider Name (Legal Business Name): TIEH MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 FRY RD STE 200
CYPRESS TX
77433-8152
US

IV. Provider business mailing address

3811 ALDER PASS CT
KATY TX
77449-7501
US

V. Phone/Fax

Practice location:
  • Phone: 832-975-7288
  • Fax: 832-975-7287
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER TIEH
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 832-434-8286