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Organization

MID TOWN OB GYN ASSOCIATES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BLANCHARD TUCKER HOLLINS (PRESIDENT)
(713) 675-1749
Entity
Organization

Contact information

Practice address
4315 LOCKWOOD DR, HOUSTON, TX 77026-4117
(713) 675-1749
(713) 670-8190
Mailing address
4315 LOCKWOOD DR, HOUSTON, TX 77026-4117
(713) 675-1749
(713) 670-8190

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
C17040
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
129169203
TEXAS HEALTH NETWORK
TX
05
80W240
TX
Enumeration date
04/06/2007
Last updated
08/11/2009
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