Provider Demographics
NPI:1235515560
Name:TLG PHYSICIANS PLLC
Entity type:Organization
Organization Name:TLG PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSQUERA PALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-838-0800
Mailing Address - Street 1:6800 WEST LOOP S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4528
Mailing Address - Country:US
Mailing Address - Phone:713-838-0887
Mailing Address - Fax:
Practice Address - Street 1:6800 WEST LOOP S
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4528
Practice Address - Country:US
Practice Address - Phone:713-838-0887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6077207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty