Provider Demographics
NPI:1790389062
Name:TOTAL ACCESS MEDICAL DIRECTORY LLC
Entity Type:Organization
Organization Name:TOTAL ACCESS MEDICAL DIRECTORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNDAR
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:DHAMOTHARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-203-5992
Mailing Address - Street 1:16610 MYSTIC HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-4597
Mailing Address - Country:US
Mailing Address - Phone:346-205-4388
Mailing Address - Fax:866-611-7531
Practice Address - Street 1:1946 PASADENA BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-2742
Practice Address - Country:US
Practice Address - Phone:832-203-5992
Practice Address - Fax:866-611-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty