MEDICARE: INTERNAL MEDICINE ASSOCIATES OF SUGAR LAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		TX

General Provider Information

NPI Number	:	1396852158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL MEDICINE ASSOCIATES OF SUGAR LAND

Provider Business Mailing Address
First Line	:	7616 BRANFORD PL STE 120
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3794
Country	:	US
Telephone Number	:	281-207-0123
Fax Number	:	281-494-8899

Provider Business Practice Location Address
First Line	:	7616 BRANFORD PL STE 120
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3794
Country	:	US
Telephone Number	:	281-207-0123
Fax Number	:	281-494-8899

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CLYDE DONALD FORD
Credential	:	MD
Telephone Number	:	281-207-0123

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	04/15/2020

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