MEDICARE: PERIOPERATIVE AND INTERNAL MEDICINE GROUP PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1750028957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERIOPERATIVE AND INTERNAL MEDICINE GROUP PLLC

Provider Business Mailing Address
First Line	:	8220 WALNUT HILL LN STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4433
Country	:	US
Telephone Number	:	214-238-3074
Fax Number	:	214-238-3608

Provider Business Practice Location Address
First Line	:	8220 WALNUT HILL LN STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4433
Country	:	US
Telephone Number	:	214-238-3074
Fax Number	:	214-238-3608

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAMAL QAMAR LONE
Credential	:	MD
Telephone Number	:	214-577-1824

Provider Enumeration Date	:	05/18/2022
Last Update Date	:	10/03/2022

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