Healthcare Provider Details
I. General information
NPI: 1316352628
Provider Name (Legal Business Name): THOMAS CRAIG SEGERSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2014
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US
IV. Provider business mailing address
18951 N MEMORIAL DR
HUMBLE TX
77338-4217
US
V. Phone/Fax
- Phone: 281-540-7700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MT206024 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | R3956 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: