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General NPI Number Information
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NPI Number | 1619347200
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Entity Type | Organization
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Legal Business Name | TEXAS MEDICAL ALLIANCE INC
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Dates
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Enumeration Date | 09/25/2015
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 16225 PARK TEN PL STE 500
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City | HOUSTON
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State | TX
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Zip | 77084-5152
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Country | US
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Telephone | 713-395-4002
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Fax | 832-530-0300
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Provider Business Mailing Address
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Address Line | 16225 PARK TEN PL STE 500
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City | HOUSTON
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State | TX
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Zip | 77084-5152
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Country | US
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Telephone | 713-338-4002
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Fax | 713-338-3410
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | H LUNA
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Credential |
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Telephone | 713-395-4002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 596118
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License Number State | TX
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