Provider Demographics
NPI:1316001910
Name:EUGENE NUNNERY
Entity Type:Organization
Organization Name:EUGENE NUNNERY
Other - Org Name:INTERNAL MEDICINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-425-4982
Mailing Address - Street 1:1713 TREASURE HILLS BLVD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8913
Mailing Address - Country:US
Mailing Address - Phone:956-425-4982
Mailing Address - Fax:956-421-4051
Practice Address - Street 1:1713 TREASURE HILLS BLVD
Practice Address - Street 2:SUITE 2D
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8913
Practice Address - Country:US
Practice Address - Phone:956-425-4982
Practice Address - Fax:956-421-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084247801Medicaid
TX084247801Medicaid