TMC Provider Group, PLLC
Organization Active NPI Urgent Care Clinic/Center · Pflugerville, TX
NPI 1104535129 · NPPES record last updated Nov 17, 2022
Key facts
- NPI
- 1104535129
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- TMC PROVIDER GROUP, PLLC
- Practice address
- 1501 FM 685
Pflugerville, TX 78660-3576 - Phone
- (337) 202-0720
- NPI assigned
- Nov 17, 2022
- Organization subpart
- No
Authorized official
- Name
- Erica Hauser
- Title
- President
- Phone
- (312) 590-5372
Other NPIs on the same Medicare enrollment 25
Practitioners 7
-
Rodrigo David Cantu, M.D.
-
Karen D Carroll, FNP
-
Steven Rene Chavez, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2273317 | Texas Medclinic PLCC | Provider-performed microscopy | Jan 31, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160127002626 | TX | Part B Supplier - Clinic/Group Practice | 6305149121 |
Receives reassigned benefits from 286 practitioners 25 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Round Rock, TX; San Antonio, TX; Selma, TX; Spring, TX; Spring Branch, TX; Vidor, TX; Jarrell, TX; Austin, TX… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
1501 FM 685
Pflugerville, TX 78660-3576
Mailing address
PO Box 4165
Portland, OR 97208-4165
Other names
- Texas MedClinic
NPI Registry JSON
{
"created_epoch": "1668643200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1668643200000",
"number": "1104535129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4165",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972084165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 FM 685",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603576",
"telephone_number": "337-202-0720"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TMC PROVIDER GROUP, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-17",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A",
"authorized_official_last_name": "HAUSER",
"authorized_official_first_name": "ERICA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "312-590-5372"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Texas MedClinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pflugerville, TX
- Jazmane Thompson
- Maddison Thompson
- Shawntrey Thompson
- Crystal Thornton
- Kimberlee Gay Tiritilli
- Jenny Rose Tobat
- Sally E Tomasek
- Yolanda Toms
- Dale Wayne Tope
- Torches of Hope
All providers in Pflugerville, TX · Urgent Care Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.