MEDICARE: TYMON TAI MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1407377732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYMON TAI MD

Provider Business Mailing Address
First Line	:	6431 FANNIN ST
Second Line	:	MSB 5.036
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 TRAVIS ST STE 900
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1336
Country	:	US
Telephone Number	:	832-353-2880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2017
Last Update Date	:	05/03/2022

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