Provider Demographics
NPI:1942480538
Name:MIDTOWN MEDICAL GROUP, LLP
Entity Type:Organization
Organization Name:MIDTOWN MEDICAL GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-650-1900
Mailing Address - Street 1:4140 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 515
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7412
Mailing Address - Country:US
Mailing Address - Phone:713-650-1900
Mailing Address - Fax:713-650-6368
Practice Address - Street 1:4140 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 515
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7412
Practice Address - Country:US
Practice Address - Phone:713-650-1900
Practice Address - Fax:713-650-6368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6029207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0811234-01Medicaid
TX113442102Medicaid
TX131482505OtherMEDICAID PIN DR. HOLMES
TX1134106651OtherDR. HOLMES NPI
TX113442102OtherMEDICAID PIN DR. RANA
TX0021EMOtherBC GROUP
TX8403KOOtherMEDICARE PIN DR. RANA
TX1063496549OtherDR. RANA NPI
TX8403K2OtherMEDICARE PIN DR. HOLMES
8403K2Medicare PIN
TX1134106651OtherDR. HOLMES NPI
C17052Medicare UPIN
TX113442102OtherMEDICAID PIN DR. RANA
TX0811234-01Medicaid