| Tmc Provider Group Pllc | |
|
9207 N Loop 1604 W San Antonio TX 78249-2513 | |
| (210) 695-4884 | |
| (210) 695-4949 |
| Full Name | Tmc Provider Group Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9207 N Loop 1604 W, San Antonio, Texas |
| Authorized Official Name and Position | Erica Hauser (PRESIDENT) |
| Authorized Official Contact | 3125905372 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tmc Provider Group Pllc Po Box 4165 Portland OR 97208-4165 Ph: (210) 349-5577 | Tmc Provider Group Pllc 9207 N Loop 1604 W San Antonio TX 78249-2513 Ph: (210) 695-4884 |
| NPI Number | 1730553025 |
|---|---|
| Provider Enumeration Date | 11/24/2015 |
| Last Update Date | 03/21/2023 |
| Medicare PECOS PAC ID | 6305149121 |
|---|---|
| Medicare Enrollment ID | O20160711001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730553025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
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