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General NPI Number Information
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NPI Number | 1659518702
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Entity Type | Organization
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Legal Business Name | T.A. MEDICAL L.L.C.
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 2136 YALE ST STE A
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City | HOUSTON
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State | TX
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Zip | 77008-2528
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Country | US
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Telephone | 713-868-2426
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Fax | 713-861-4588
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Provider Business Mailing Address
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Address Line | 2136 YALE ST STE A
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City | HOUSTON
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State | TX
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Zip | 77008-2528
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Country | US
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Telephone | 713-868-2426
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Fax | 713-861-4588
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARCO TAPIA JR.
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Credential | M.A., A.A.
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Telephone | 713-868-2426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 96187
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J7213
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License Number State | TX
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