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NPI Code Detail

MEDICARE: WACO INTERNAL MEDICINE ASSOCIATES, P.A.

MEDICARE: WACO INTERNAL MEDICINE ASSOCIATES, P.A.
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1891844585
Entity Type Code : Organization
Provider Name (Legal Business Name) : WACO INTERNAL MEDICINE ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : 2800 LYLE AVE
Second Line :
City : WACO
State : TX
Zip : 76708-2680
Country : US
Telephone Number : 254-756-7091
Fax Number : 254-754-2666
Provider Business Practice Location Address
First Line : 2800 LYLE AVE
Second Line :
City : WACO
State : TX
Zip : 76708-2680
Country : US
Telephone Number : 254-756-7091
Fax Number : 254-754-2666
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROSS F SHIPP
Credential : M.D.
Telephone Number : 254-756-7091
Provider Enumeration Date : 01/10/2007
Last Update Date : 12/17/2008

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Directions to “WACO INTERNAL MEDICINE ASSOCIATES, P.A. ” Practice Location

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