Provider Demographics
NPI:1366792863
Name:QUIGLEY, EAMONN MARTIN (MD)
Entity type:Individual
Prefix:
First Name:EAMONN
Middle Name:MARTIN
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-3372
Mailing Address - Fax:713-797-0622
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-3372
Practice Address - Fax:713-797-0622
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45649207RG0100X
TX43968207RG0100X
TX46451207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01704738OtherRR MEDICARE
TX8EE351OtherBLUE CROSS BLUE SHIELD
TX319326002Medicaid
TX8DN915OtherBLUE CROSS BLUE SHIELD
TX319326003Medicaid
TX319326001Medicaid
TX1366792863OtherBLUE CROSS BLUE SHIELD
TX265514YMVQMedicare PIN
TX8DN915OtherBLUE CROSS BLUE SHIELD
TX319326002Medicaid