Provider Demographics
NPI:1023338324
Name:INTERNAL MEDICINE ASSOCIATES OF HUNTSVILLE, PLLC
Entity type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF HUNTSVILLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-852-1550
Mailing Address - Street 1:1524 11TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-3800
Mailing Address - Country:US
Mailing Address - Phone:936-436-1786
Mailing Address - Fax:936-435-1109
Practice Address - Street 1:1524 11TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3800
Practice Address - Country:US
Practice Address - Phone:936-436-1786
Practice Address - Fax:936-435-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty