Provider Demographics
NPI:1376655647
Name:TLB II, P.C.
Entity Type:Organization
Organization Name:TLB II, P.C.
Other - Org Name:CAPE COD MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BILIOURIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-394-7113
Mailing Address - Street 1:65 ROUTE 134
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-3762
Mailing Address - Country:US
Mailing Address - Phone:508-394-7113
Mailing Address - Fax:508-394-5470
Practice Address - Street 1:65 ROUTE 134
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3762
Practice Address - Country:US
Practice Address - Phone:508-394-7113
Practice Address - Fax:508-394-5470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9786562Medicaid
MA9786562Medicaid