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General NPI Number Information
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NPI Number | 1588526628
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Entity Type | Organization
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Legal Business Name | TMC PROVIDER GROUP, PLLC
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 14426 W STATE HIGHWAY 71
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City | AUSTIN
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State | TX
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Zip | 78738-2907
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Country | US
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Telephone | 512-675-2384
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Fax | 512-900-8101
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Provider Business Mailing Address
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Address Line | PO BOX 4165
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City | PORTLAND
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State | OR
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Zip | 97208-4165
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Country | US
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Telephone | 726-201-3368
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Fax | 458-234-4485
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERICA HAUSER
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Credential |
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Telephone | 312-590-5372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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