Provider Demographics
NPI:1598779555
Name:GENERAL INFECTIOUS DISEASE ASSOCIATES
Entity Type:Organization
Organization Name:GENERAL INFECTIOUS DISEASE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKUCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-412-2821
Mailing Address - Street 1:3808 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1933
Mailing Address - Country:US
Mailing Address - Phone:713-412-2821
Mailing Address - Fax:281-993-4453
Practice Address - Street 1:3808 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1933
Practice Address - Country:US
Practice Address - Phone:713-412-2821
Practice Address - Fax:281-993-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2528207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8F3818OtherINDIVIDUAL MEDICARE PIN LINKED TO MEDICARE GROUP # 00W951
TX800679333OtherFILE NUMBER
00W951Medicare PIN