# MDLIVE MEDICAL GROUP TX PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MDLIVE MEDICAL GROUP TX PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649987066
- **Legal business name:** MDLIVE MEDICAL GROUP TX PLLC
- **Authorized official:** SUE-ANN ADRIANS (GP PM)
- **Authorized official phone:** (800) 400-6354

## Contact information

- **Practice address:** 900 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-2920
- **Practice address phone:** (800) 400-6354
- **Mailing address:** PO BOX 5006, HARTFORD, CT 06102-5006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 11/04/2022
- **Last updated:** 04/10/2026