Provider Demographics
NPI:1134998073
Name:TAM CAPITAL VENTURES
Entity type:Organization
Organization Name:TAM CAPITAL VENTURES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:708-699-6688
Mailing Address - Street 1:2540 N GALLOWAY AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4814
Mailing Address - Country:US
Mailing Address - Phone:972-779-0007
Mailing Address - Fax:513-987-9512
Practice Address - Street 1:2540 N GALLOWAY AVE STE 303
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4814
Practice Address - Country:US
Practice Address - Phone:972-779-0007
Practice Address - Fax:513-987-9512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty