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General NPI Number Information
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NPI Number | 1548344401
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Entity Type | Organization
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Legal Business Name | THE INTERNAL MEDICINE CENTER, P.A.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 2310 DE LEE ST
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City | BRYAN
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State | TX
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Zip | 77802-2815
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Country | US
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Telephone | 979-774-0400
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Fax | 979-774-8908
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Provider Business Mailing Address
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Address Line | 2310 DE LEE ST
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City | BRYAN
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State | TX
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Zip | 77802-2815
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Country | US
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Telephone | 979-774-0400
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Fax | 979-774-8908
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH CATHERINE BERIGAN
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Credential | M.D.
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Telephone | 979-774-0400
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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 | J4716
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License Number State | TX
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