Provider Demographics
NPI:1154038388
Name:DMRESTOR CLINIC PLLC
Entity type:Organization
Organization Name:DMRESTOR CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:TAIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-668-3311
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 1200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8235
Mailing Address - Country:US
Mailing Address - Phone:832-426-4394
Mailing Address - Fax:713-239-0142
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 1200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8235
Practice Address - Country:US
Practice Address - Phone:832-426-4394
Practice Address - Fax:713-239-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty