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Get and Sign Tmhp 2012 Form

Get and Sign Tmhp 2012 Form

Use a Tmhp 2012 template to make your document workflow more streamlined.

Address at the bottom of the page. Date / Nine-Digit Texas Provider Identifier TPI Provider Name National Provider Identifier NPI Primary Taxonomy Code Atypical Provider Identifier API Benefit Code List any additional TPIs that use the same provider information TPI Physical Address The physical address cannot be a PO Box. Ambulatory Surgical Centers enrolled with Traditional Medicaid who change their ZIP Code must submit a copy of the Medicare letter along with this form* Street address...
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