Healthcare Provider Details

I. General information

NPI: 1538448212
Provider Name (Legal Business Name): TMH PHYSICIAN ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2011
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 LAKE POINTE PKWY SUITE 425
SUGAR LAND TX
77478-4095
US

IV. Provider business mailing address

1327 LAKE POINTE PKWY SUITE 425
SUGAR LAND TX
77478-4095
US

V. Phone/Fax

Practice location:
  • Phone: 281-690-4678
  • Fax:
Mailing address:
  • Phone: 281-690-4678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateTX

VIII. Authorized Official

Name: ROBERT A. PHILLIPS
Title or Position: PRESIDENT AND CEO
Credential: M.D.
Phone: 713-441-7963