Provider Demographics
NPI:1992884779
Name:TEXAS INSTITUTE OF PULMONARY AND SLEEP MEDICINE, PA
Entity type:Organization
Organization Name:TEXAS INSTITUTE OF PULMONARY AND SLEEP MEDICINE, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PIRTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-357-0111
Mailing Address - Street 1:PO BOX 259
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-0259
Mailing Address - Country:US
Mailing Address - Phone:281-357-0111
Mailing Address - Fax:281-355-9639
Practice Address - Street 1:27933 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6415
Practice Address - Country:US
Practice Address - Phone:281-357-0111
Practice Address - Fax:281-255-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8189174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC0362OtherRAILROAD MEDICARE
TX0067KZOtherBLUE CROSS BLUE SHIELD
TX170237501Medicaid
TX170237501Medicaid