Provider Demographics
NPI:1548489222
Name:TEXAS MEDICAL GROUP, PA
Entity type:Organization
Organization Name:TEXAS MEDICAL GROUP, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-284-7000
Mailing Address - Street 1:PO BOX 679705
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-9705
Mailing Address - Country:US
Mailing Address - Phone:972-284-7000
Mailing Address - Fax:214-292-8787
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 230
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:972-284-7000
Practice Address - Fax:972-284-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDN5025OtherMEDICARE RAILROAD
TX193777301Medicaid
TXEC0384OtherRAILROAD MEDICARE
TX0055PVOtherBCBS