Mid Town OB GYN Associates, Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

C17040 Issued in TX

Legal business name

MID TOWN OB GYN ASSOCIATES, INC

Practice address

4315 Lockwood Dr
Houston, TX 77026-4117

Phone

(713) 675-1749

Fax

(713) 670-8190

NPI assigned

Apr 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Blanchard Tucker Hollins

Title

President

Phone

(713) 675-1749

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1487776670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 LOCKWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770264117",
            "telephone_number": "713-675-1749",
            "fax_number": "713-670-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 LOCKWOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770264117",
            "telephone_number": "713-675-1749",
            "fax_number": "713-670-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID TOWN OB GYN ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "HOLLINS",
        "authorized_official_first_name": "BLANCHARD",
        "authorized_official_middle_name": "TUCKER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-675-1749",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "TX",
            "license": "C17040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS HEALTH NETWORK",
            "identifier": "129169203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80W240",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Houston, TX
• Providers in Houston, TX by specialty
• Health Maintenance Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.