Provider Demographics
NPI:1447295910
Name:TEXAS MEDICAL AND SURGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:TEXAS MEDICAL AND SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRESLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-345-1494
Mailing Address - Street 1:8440 WALNUT HILL LN STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3833
Mailing Address - Country:US
Mailing Address - Phone:214-345-1400
Mailing Address - Fax:214-345-1452
Practice Address - Street 1:8440 WALNUT HILL LN STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3833
Practice Address - Country:US
Practice Address - Phone:214-345-1400
Practice Address - Fax:214-345-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RR0500X, 207V00000X, 207Y00000X, 208000000X, 208800000X, 363AM0700X
TXJ7019208000000X
TXJ3359208800000X
TXL1570207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN91XMedicare PIN
TXN91XMedicare PIN