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General NPI Number Information
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NPI Number | 1528183621
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE & NEPHROLOGY ASSOCIATES, PA
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 210 W PARK STE 104
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City | LIVINGSTON
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State | TX
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Zip | 77351-8337
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Country | US
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Telephone | 936-328-5820
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Fax | 936-328-5824
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Provider Business Mailing Address
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Address Line | 210 W PARK STE 104
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City | LIVINGSTON
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State | TX
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Zip | 77351-8337
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Country | US
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Telephone | 936-328-5820
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Fax | 936-328-5824
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | RHONDA KNOEDLER
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Credential | BS
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Telephone | 936-328-5820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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