Provider Demographics
NPI:1639430283
Name:HEALING INTERNAL MEDICINE CLINIC
Entity Type:Organization
Organization Name:HEALING INTERNAL MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AFZAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-446-2227
Mailing Address - Street 1:601 RIVER POINTE DR STE 100
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2943
Mailing Address - Country:US
Mailing Address - Phone:936-446-2227
Mailing Address - Fax:936-788-2221
Practice Address - Street 1:601 RIVER POINTE DR STE 100
Practice Address - Street 2:SUITE # 100
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2943
Practice Address - Country:US
Practice Address - Phone:936-446-2227
Practice Address - Fax:936-788-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1957207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty