MEDICARE: TMH PHYSICIAN ORGANIZATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	208000000X	Pediatrics Physician
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1831862291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TMH PHYSICIAN ORGANIZATION

Provider Business Mailing Address
First Line	:	PO BOX 102720
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91189-0124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 KIRBY DR STE 1A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1879
Country	:	US
Telephone Number	:	888-663-6331
Fax Number	:	415-291-0489

Authorized Official
Title or Position	:	VP
Name	:	JEFF CARR
Credential	:
Telephone Number	:	346-356-1672

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	08/03/2021

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