Provider Demographics
NPI:1407036163
Name:TOWN AND COUNTRY INTERNAL MEDICINE, P.A.
Entity Type:Organization
Organization Name:TOWN AND COUNTRY INTERNAL MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AGADADASH
Authorized Official - Middle Name:
Authorized Official - Last Name:KULIEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-463-5527
Mailing Address - Street 1:1140 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043
Mailing Address - Country:US
Mailing Address - Phone:713-463-5527
Mailing Address - Fax:713-463-3784
Practice Address - Street 1:1140 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043
Practice Address - Country:US
Practice Address - Phone:713-463-5527
Practice Address - Fax:713-463-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-11
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty