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NPI Profile for CREEKSIDE PREMIER MEDICAL GROUP PLLC in TOMBALL, TX.
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hematology & Oncology |
207RH0003X | 11 | Physician/Internal Medicine | |
Allergy & Immunology |
207K00000X | 03 | Physician/Allergy/ Immunology | |
Anesthesiology |
207L00000X | 79 | Physician/Addiction Medicine | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Gastroenterology |
207RG0100X | 10 | Physician/Gastroenterology | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Neurological Surgery |
207T00000X | 02 | Physician/General Surgery | |
Pain Medicine |
208VP0000X | 72 | Physician/Pain Management | |
Physical Medicine & Rehabilitation |
208100000X | 25 | Physician/Physical Medicine and Rehabilitation | |
Rheumatology |
207RR0500X | 11 | Physician/Internal Medicine | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry | |
Urogynecology and Reconstructive Pelvic Surgery |
207VF0040X | 16 | Physician/Obstetrics & Gynecology |
| NPI # | 1487217006 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/18/2019 | |
| Last updated | 08/27/2025 - About 9 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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CREEKSIDE PREMIER MEDICAL GROUP PLLC
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CREEKSIDE PREMIER MEDICAL GROUP PLLC