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NPI Code Detail

MEDICARE: TRICIA PUNSALAN M.D.

MEDICARE: TRICIA PUNSALAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist PhysicianN2740TX
2207Q00000XFamily Medicine PhysicianN2740TX

General Provider Information

NPI Number : 1003020504
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRICIA PUNSALAN M.D.
Provider Business Mailing Address
First Line : 504 MEDICAL CENTER BLVD
Second Line :
City : CONROE
State : TX
Zip : 77304-2808
Country : US
Telephone Number : 936-718-3831
Fax Number : 888-501-5341
Provider Business Practice Location Address
First Line : 704 OLD MONTGOMERY RD
Second Line :
City : CONROE
State : TX
Zip : 77301-2740
Country : US
Telephone Number : 936-539-4004
Fax Number : 936-521-3964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/05/2016

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Directions to “ TRICIA PUNSALAN M.D.” Practice Location

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