Provider Demographics
NPI:1679515076
Name:MY DOCTOR, P.A.
Entity Type:Organization
Organization Name:MY DOCTOR, P.A.
Other - Org Name:HUNTSVILLE PEDIATRIC AND ADULT MEDICINE ASSCOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-295-8000
Mailing Address - Street 1:PO BOX 8570
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-0010
Mailing Address - Country:US
Mailing Address - Phone:936-295-8000
Mailing Address - Fax:936-439-1169
Practice Address - Street 1:100 MEDICAL CENTER PKWY
Practice Address - Street 2:SUITE 1000
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4945
Practice Address - Country:US
Practice Address - Phone:936-295-8000
Practice Address - Fax:936-439-1169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
00N38NMedicare PIN