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General NPI Number Information
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NPI Number | 1558080416
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Entity Type | Organization
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Legal Business Name | TEXAS INTEGRATED MEDICAL SPECIALISTS, PLLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 2000 SCENIC DR STE G002
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City | GEORGETOWN
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State | TX
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Zip | 78626-7726
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Country | US
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Telephone | 512-531-5200
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Fax | 512-865-4068
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Provider Business Mailing Address
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Address Line | 2000 SCENIC DR STE G002
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City | GEORGETOWN
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State | TX
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Zip | 78626-7726
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Country | US
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Telephone | 512-531-5200
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Fax | 512-865-4068
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | ELIZABETH CRUZ
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Credential |
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Telephone | 512-531-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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