Provider Demographics
NPI:1083127773
Name:MIDTOWN MEDICAL GROUP, LLP
Entity Type:Organization
Organization Name:MIDTOWN MEDICAL GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-650-1900
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 1400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8237
Mailing Address - Country:US
Mailing Address - Phone:281-727-3405
Mailing Address - Fax:281-727-3490
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8237
Practice Address - Country:US
Practice Address - Phone:281-727-3405
Practice Address - Fax:281-727-3490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty