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General NPI Number Information
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NPI Number | 1295109064
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE ASSOCIATES OF TEXAS
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 12720 HILLCREST RD STE 725
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City | DALLAS
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State | TX
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Zip | 75230-7110
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Country | US
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Telephone | 972-566-8899
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Fax | 972-566-5775
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Provider Business Mailing Address
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Address Line | 9330 LBJ FWY STE 800
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City | DALLAS
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State | TX
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Zip | 75243-4310
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Country | US
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Telephone | 972-792-5700
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Fax | 214-506-1170
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | DIANE MURR-HEWITT
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Credential |
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Telephone | 972-792-5700
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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 | J8754
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License Number State | TX
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