=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598072381
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOUGLAS S TSUCHIDA MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2010
-----------------------------------------------------
Last Update Date | 09/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 915 GESSNER RD SUITE 815
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-827-1000
-----------------------------------------------------
Fax | 713-722-0639
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 915 GESSNER RD SUITE 815
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-827-1000
-----------------------------------------------------
Fax | 713-722-0639
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DOUGLAS S TSUCHIDA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 713-827-1000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | F0055
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------