Provider Demographics
NPI:1093977340
Name:MIDTOWN PHYSICIANS,LTD.,L.L.P.
Entity Type:Organization
Organization Name:MIDTOWN PHYSICIANS,LTD.,L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:MISS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-522-1788
Mailing Address - Street 1:3306 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-2904
Mailing Address - Country:US
Mailing Address - Phone:713-522-1788
Mailing Address - Fax:713-522-9177
Practice Address - Street 1:3306 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-2904
Practice Address - Country:US
Practice Address - Phone:713-522-1788
Practice Address - Fax:713-522-9177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7236207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033862601Medicaid
TX033862601Medicaid
TX00HH52Medicare PIN