Provider Demographics
NPI:1659475234
Name:TOWER MEDICAL CENTER OF PORT NECHES
Entity Type:Organization
Organization Name:TOWER MEDICAL CENTER OF PORT NECHES
Other - Org Name:TOWER MEDICAL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:LANG
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-727-7342
Mailing Address - Street 1:2501 JIMMY JOHNSON BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-2000
Mailing Address - Country:US
Mailing Address - Phone:409-727-7342
Mailing Address - Fax:409-722-0958
Practice Address - Street 1:2501 JIMMY JOHNSON BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2000
Practice Address - Country:US
Practice Address - Phone:409-727-7342
Practice Address - Fax:409-722-0958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1720207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0849275-01Medicaid
TXH1720OtherDR. LANG-WILLIAMS, LIC #
TX0849275-01Medicaid
TX00R85CMedicare ID - Type UnspecifiedPROVIDER NUMBER
TX=========OtherTAX ID