Provider Demographics
| NPI: | 1235183096 |
|---|---|
| Name: | TMH PHYSICIAN ORGANIZATION |
| Entity Type: | Organization |
| Organization Name: | TMH PHYSICIAN ORGANIZATION |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXEC VP & CMO-HMHS,PRESCEO-HMSPG |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | ROBERT |
| Authorized Official - Middle Name: | A |
| Authorized Official - Last Name: | PHILLIPS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD,PHD,FACC |
| Authorized Official - Phone: | 713-441-7389 |
| Mailing Address - Street 1: | 6550 FANNIN ST |
| Mailing Address - Street 2: | SUITE 447 |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77030-2717 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-441-7389 |
| Mailing Address - Fax: | 713-793-7012 |
| Practice Address - Street 1: | 6550 FANNIN ST |
| Practice Address - Street 2: | SUITE 447 |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77030-2717 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 713-441-7389 |
| Practice Address - Fax: | 713-793-7012 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-05-19 |
| Last Update Date: | 2015-08-24 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2086S0129X | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | Group - Multi-Specialty |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207LC0200X | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | Group - Multi-Specialty |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 179960301 | Medicaid | |
| TX | 172037703 | Medicaid | |
| TX | 0095LZ | Other | MAIN BCBS NUMBER |
| TX | 207803201 | Medicaid | |
| TX | 172037701 | Medicaid | |
| TX | 330448701 | Medicaid | |
| TX | TXB131136 | Medicare PIN | |
| TX | 00750W | Medicare PIN | |
| TX | 179960301 | Medicaid | |
| TX | 0A0232 | Medicare PIN | |
| TX | 00W174 | Medicare PIN | |
| TX | 172037703 | Medicaid | |
| TX | 347996 | Medicare PIN |
