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General NPI Number Information
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NPI Number | 1851035216
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Entity Type | Organization
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Legal Business Name | TPG TEXAS PLLC
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 945 MCKINNEY ST STE 19564
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City | HOUSTON
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State | TX
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Zip | 77002-6308
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Country | US
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Telephone | 628-260-5154
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Fax |
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Provider Business Mailing Address
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Address Line | 945 MCKINNEY ST STE 19564
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City | HOUSTON
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State | TX
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Zip | 77002-6308
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Country | US
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Telephone | 628-260-5154
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEKULEO GATHERS
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Credential | MD
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Telephone | 917-533-7354
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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 |
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License Number State |
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