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General NPI Number Information
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NPI Number | 1891592044
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Entity Type | Organization
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Legal Business Name | TMC PROVIDER GROUP, PLLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 19055 IH 35 N UNIT 4
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City | KYLE
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State | TX
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Zip | 78640-6772
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Country | US
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Telephone | 512-265-6759
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Fax | 512-201-6179
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Provider Business Mailing Address
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Address Line | PO BOX 4165
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City | PORTLAND
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State | OR
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Zip | 97208-4165
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERICA HAUSER
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Credential |
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Telephone | 312-590-5372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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