Provider Demographics
NPI:1497876437
Name:TECSON, SHEILA LIBERTY (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:LIBERTY
Last Name:TECSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249
Mailing Address - Street 2:SUITE 390
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-737-0899
Mailing Address - Fax:281-737-0892
Practice Address - Street 1:18220 STATE HIGHWAY 249
Practice Address - Street 2:SUITE 390
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-737-0899
Practice Address - Fax:281-737-0892
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116020919207Q00000X
TXN7754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CT933OtherBLUE CROSS BLUE SHIELD
TX281641501Medicaid
TX281641502Medicaid
TXP01055704OtherMEDICARE RR
TXTXB127839Medicare PIN
TX281641501Medicaid
TX332448YMVQMedicare PIN