Mid-South Medical Management LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MID-SOUTH MEDICAL MANAGEMENT LLC

Practice address

8105 Rasor Blvd Ste 120
Plano, TX 75024-0336

Phone

(214) 210-0606

Fax

(855) 844-1068

NPI assigned

Feb 20, 2024

Organization subpart

No

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

Authorized official

Name

Beverly Brown-Harris

Title

President

Phone

(214) 210-0606

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MS, LA3 enrollments

Enrollment records 3

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Oswald Shannon, MD

  • Plastic and Reconstructive Surgery Physician
  • The Woodlands, TX
  • NPI 1689781841
  Medicare reassignment Care Compare group NPD
• Obie M. McNair, M.D.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1851321384
  Medicare reassignment Care Compare group NPD
• Philip Bouchette, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1750813259
  Medicare reassignment

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1689439481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 RASOR BLVD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750240336",
            "telephone_number": "214-210-0606",
            "fax_number": "855-844-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8105 RASOR BLVD STE 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750240336",
            "telephone_number": "214-210-0606",
            "fax_number": "855-844-1068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4780 I 55 N Ste 275-2",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392115542",
            "country_code": "US",
            "telephone_number": "844-679-6863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MID-SOUTH MEDICAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "BROWN-HARRIS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-210-0606"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Sun MD PA
• Victoria L Michener, FNP
• Megan Mickels, NONE
• Micky Ahluwalia MD
• Microsurgery Spine and Pain Institute
• Janet May Mida, RNC, WHNP
• Gary Randall Middleton II, D.D.S.
• Midway Eye Associates
• Vivian Uyen Mielcarek, DDS
• Margaret Louise Miesch, M.D

• Internal Medicine Physician in Plano, TX
• Providers in Plano, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.