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NPI Code Detail

MEDICARE: ALLIANCE PHYSICIANS GROUP OF TEXAS, PLLC

MEDICARE: ALLIANCE PHYSICIANS GROUP OF TEXAS, PLLC
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
1207R00000XInternal Medicine PhysicianK0347TX

General Provider Information

NPI Number : 1063609261
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIANCE PHYSICIANS GROUP OF TEXAS, PLLC
Provider Business Mailing Address
First Line : PO BOX 1729
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-1729
Country : US
Telephone Number : 409-722-6553
Fax Number : 409-729-1500
Provider Business Practice Location Address
First Line : 2210 HIGHWAY 365
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-5506
Country : US
Telephone Number : 409-722-6553
Fax Number : 409-729-1500
Authorized Official
Title or Position : MANAGING BOARD MEMBER/PHYSICIAN
Name : MICHAEL LLOYD MCMAHON II
Credential : M.D.
Telephone Number : 409-722-6553
Provider Enumeration Date : 10/02/2007
Last Update Date : 10/02/2007

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