Provider Demographics
NPI:1376736645
Name:AMERICAN INTERNAL MEDICINE SERVICES,P.A.,
Entity Type:Organization
Organization Name:AMERICAN INTERNAL MEDICINE SERVICES,P.A.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:GOMEZ LOZANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-494-6713
Mailing Address - Street 1:122 N INTERNATIONAL RD
Mailing Address - Street 2:STE B
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6530
Mailing Address - Country:US
Mailing Address - Phone:972-494-6713
Mailing Address - Fax:972-494-5034
Practice Address - Street 1:122 N INTERNATIONAL RD
Practice Address - Street 2:STE B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6530
Practice Address - Country:US
Practice Address - Phone:972-494-6713
Practice Address - Fax:972-494-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5332207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130915501Medicaid
TX0030EBOtherBC/BS
TXCG9526OtherRAILROAD MEDICARE
TX00123DMedicare PIN
TXCG9526OtherRAILROAD MEDICARE