Provider Demographics
NPI:1275975120
Name:IN MED SYSTEMS, LLC
Entity Type:Organization
Organization Name:IN MED SYSTEMS, LLC
Other - Org Name:INTEGRATED MEDICAL SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMUNOMIEBAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:OPUIYO
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:832-647-1095
Mailing Address - Street 1:2006 CALDBECK LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-6087
Mailing Address - Country:US
Mailing Address - Phone:713-538-8163
Mailing Address - Fax:713-538-8163
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:713-538-8163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-20
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile