Provider Demographics
NPI:1720141971
Name:TMH PHYSICIAN ORGANIZATION
Entity Type:Organization
Organization Name:TMH PHYSICIAN ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:OPPERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-275-0860
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1601
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-6172
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1601
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-6172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9556208600000X
PAMD427279282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196641801Medicaid
TX196641802Medicaid
TXP00635398OtherRAILROAD MEDICARE
TX8BC028OtherBLUE CROSS BLUE SHIELD
TX196641803Medicaid
TX8BC028OtherBLUE CROSS BLUE SHIELD
TXP00635398OtherRAILROAD MEDICARE
TXTXB145740Medicare PIN
TX8L12806Medicare PIN