Provider Demographics
NPI:1477717064
Name:TOMLINSON & JEZIERSKI PLLC
Entity Type:Organization
Organization Name:TOMLINSON & JEZIERSKI PLLC
Other - Org Name:MONTGOMERY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDCIAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-597-5555
Mailing Address - Street 1:873B EVA ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-1808
Mailing Address - Country:US
Mailing Address - Phone:936-597-5555
Mailing Address - Fax:936-597-5585
Practice Address - Street 1:873B EVA ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-1808
Practice Address - Country:US
Practice Address - Phone:936-597-5555
Practice Address - Fax:936-597-5585
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTGOMERY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4748208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty