Provider Demographics
NPI:1821096413
Name:MEDICAL COLLEAGUES OF TEXAS, LLP
Entity Type:Organization
Organization Name:MEDICAL COLLEAGUES OF TEXAS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-578-4817
Mailing Address - Street 1:21700 KINGSLAND BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2513
Mailing Address - Country:US
Mailing Address - Phone:281-398-7954
Mailing Address - Fax:281-578-4912
Practice Address - Street 1:21700 KINGSLAND BLVD STE 201
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2547
Practice Address - Country:US
Practice Address - Phone:281-398-7954
Practice Address - Fax:281-578-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZ000U36Z4Medicaid
TXZ000U36Z4Medicaid