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General NPI Number Information
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NPI Number | 1861446304
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Entity Type | Organization
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Legal Business Name | TEXAS ALLIANCE MEDICAL GROUP, PA
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 14770 MEMORIAL DR.
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City | HOUSTON
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State | TX
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Zip | 77079-5252
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Country | US
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Telephone | 713-330-1530
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Fax | 713-330-1535
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Provider Business Mailing Address
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Address Line | 14770 MEMORIAL # 200
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City | HOUSTON
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State | TX
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Zip | 77079-5252
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Country | US
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Telephone | 281-493-5535
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Fax | 281-493-3353
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LESLIE ALLISON
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Credential | M.D.
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Telephone | 281-977-8372
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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 |
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License Number State |
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Taxonomy #2
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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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