Provider Demographics
NPI:1912030578
Name:TEXAS INTERNAL MEDICINE
Entity Type:Organization
Organization Name:TEXAS INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-368-7787
Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:SUITE 604 BLDG 1
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4411
Mailing Address - Country:US
Mailing Address - Phone:214-368-7787
Mailing Address - Fax:214-692-7573
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 604 BLDG 1
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4411
Practice Address - Country:US
Practice Address - Phone:214-368-7787
Practice Address - Fax:214-692-7573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00DG20Medicare PIN
TXCP6162Medicare PIN