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General NPI Number Information
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NPI Number | 1447503172
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE CLINIC
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 2843 MARTINA DR
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5018
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Country | US
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Telephone | 713-594-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 2843 MARTINA DR.
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City | FRIENDSWOOD
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State | TX
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Zip | 77546
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Country | US
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Telephone | 713-594-5595
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | ANGELES SIA-ZAYAS
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Credential | M.D.
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Telephone | 713-947-9408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 720463
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License Number State | TX
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