Provider Demographics
NPI:1508834870
Name:PHYSICIAN'S INPATIENT CARE PA
Entity Type:Organization
Organization Name:PHYSICIAN'S INPATIENT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPA
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-346-2261
Mailing Address - Street 1:1301 WONDER WORLD DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7533
Mailing Address - Country:US
Mailing Address - Phone:512-753-3524
Mailing Address - Fax:512-753-3777
Practice Address - Street 1:1301 WONDER WORLD DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7533
Practice Address - Country:US
Practice Address - Phone:512-753-3524
Practice Address - Fax:512-753-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH79062Medicare UPIN
TX0025BVMedicare PIN