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General NPI Number Information
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NPI Number | 1245746494
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Entity Type | Organization
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Legal Business Name | HOUSTON INTERNAL MEDICINE GROUP PLLC
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 21214 NORTHWEST FWY
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City | CYPRESS
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State | TX
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Zip | 77429-3373
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Country | US
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Telephone | 713-210-9529
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Fax |
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Provider Business Mailing Address
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Address Line | 337 GARDEN OAKS BLVD # 91482
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City | HOUSTON
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State | TX
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Zip | 77018-5501
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Country | US
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Telephone | 713-210-9529
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENEE MARIE RICE
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Credential | DO
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Telephone | 713-210-9529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N5360
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | N5360
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License Number State | TX
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