Provider Demographics
NPI:1083267983
Name:NORTHWEST INTERNAL MEDICINE AND GERIATRICS, PA
Entity Type:Organization
Organization Name:NORTHWEST INTERNAL MEDICINE AND GERIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-550-8383
Mailing Address - Street 1:PO BOX 26531
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0531
Mailing Address - Country:US
Mailing Address - Phone:478-550-8383
Mailing Address - Fax:
Practice Address - Street 1:540 E HWY 29
Practice Address - Street 2:
Practice Address - City:BERTRAM
Practice Address - State:TX
Practice Address - Zip Code:78605
Practice Address - Country:US
Practice Address - Phone:512-355-2116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty