Provider Demographics
NPI:1659518702
Name:T.A. MEDICAL L.L.C.
Entity type:Organization
Organization Name:T.A. MEDICAL L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, AA
Authorized Official - Phone:713-868-2426
Mailing Address - Street 1:2136 YALE ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2528
Mailing Address - Country:US
Mailing Address - Phone:713-868-2426
Mailing Address - Fax:713-861-4588
Practice Address - Street 1:2136 YALE ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2528
Practice Address - Country:US
Practice Address - Phone:713-868-2426
Practice Address - Fax:713-861-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96187176B00000X
TXJ7213208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty