Provider Demographics
NPI:1235208653
Name:TAVEL, LINDA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LEE
Last Name:TAVEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:TAVEL-MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1905 HOLCOMBE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4123
Mailing Address - Country:US
Mailing Address - Phone:713-467-7423
Mailing Address - Fax:713-799-9227
Practice Address - Street 1:1905 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4123
Practice Address - Country:US
Practice Address - Phone:713-467-7423
Practice Address - Fax:713-799-9227
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5677207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB26891Medicare UPIN