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General NPI Number Information
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NPI Number | 1467059857
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Entity Type | Organization
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Legal Business Name | ADVANCED INTERNAL MEDICINE, PLLC
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 13656 BRETON RIDGE ST # AH
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City | HOUSTON
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State | TX
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Zip | 77070-6081
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Country | US
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Telephone | 281-205-5100
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Fax | 832-308-1272
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Provider Business Mailing Address
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Address Line | 13656 BRETON RIDGE ST # AH
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City | HOUSTON
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State | TX
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Zip | 77070-6081
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Country | US
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Telephone | 248-525-9108
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Fax | 832-308-1272
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Authorized Official
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Title or Position | MD
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Name | DR. KUTAYBA ALSAFADI
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Credential | MD
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Telephone | 346-666-8753
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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 |
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License Number State |
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