Provider Demographics
NPI:1295940393
Name:TEXAS PROFESSIONAL HEALTHCARE ALLIANCE, INC.
Entity type:Organization
Organization Name:TEXAS PROFESSIONAL HEALTHCARE ALLIANCE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-316-1928
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-0525
Mailing Address - Country:US
Mailing Address - Phone:409-316-1928
Mailing Address - Fax:713-344-9421
Practice Address - Street 1:12902 CLOUD DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:TX
Practice Address - Zip Code:77510-9345
Practice Address - Country:US
Practice Address - Phone:409-316-1928
Practice Address - Fax:713-344-9421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty