Provider Demographics
NPI:1447456389
Name:TEJAS MEDICAL ASSOCIATES PA
Entity type:Organization
Organization Name:TEJAS MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CIRO
Authorized Official - Middle Name:J
Authorized Official - Last Name:PORRAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-988-6677
Mailing Address - Street 1:6510 HILLCROFT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4702
Mailing Address - Country:US
Mailing Address - Phone:713-988-6677
Mailing Address - Fax:713-988-0123
Practice Address - Street 1:6510 HILLCROFT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4702
Practice Address - Country:US
Practice Address - Phone:713-988-6677
Practice Address - Fax:713-988-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1182261Q00000X
TXI24293261Q00000X
TXG1184261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB25603Medicare UPIN
TXB26171Medicare UPIN
TXI24293Medicare UPIN