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General NPI Number Information
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NPI Number | 1023121274
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Entity Type | Organization
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Legal Business Name | MIDTOWN DOCTORS GROUP, PA
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 3918 LEELAND ST
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City | HOUSTON
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State | TX
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Zip | 77003-5648
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Country | US
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Telephone | 713-528-3400
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Fax | 713-528-3377
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Provider Business Mailing Address
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Address Line | 3918 LEELAND ST
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City | HOUSTON
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State | TX
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Zip | 77003-5648
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Country | US
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Telephone | 713-528-3400
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Fax | 713-528-3377
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Authorized Official
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Title or Position | OWNER/MD
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Name | DR. RYAN T THAI
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Credential | MD
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Telephone | 713-528-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L0947
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License Number State | TX
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