Provider Demographics
NPI:1033138151
Name:ACCOMPLISHED DIAGNOSTIC MEDICAL INPATIENT TEAM, P.A.
Entity Type:Organization
Organization Name:ACCOMPLISHED DIAGNOSTIC MEDICAL INPATIENT TEAM, P.A.
Other - Org Name:ADMIT, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-490-5547
Mailing Address - Street 1:18850 REDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3570
Mailing Address - Country:US
Mailing Address - Phone:210-490-5547
Mailing Address - Fax:
Practice Address - Street 1:520 MADISON OAK DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3913
Practice Address - Country:US
Practice Address - Phone:210-297-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0065HGOtherBLUE CROSS BLUE SHIELD
TX00874RMedicare ID - Type Unspecified