Provider Demographics
NPI:1336318039
Name:CENTRAL TEXAS INTERNAL MEDICINE, P.A.
Entity Type:Organization
Organization Name:CENTRAL TEXAS INTERNAL MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:979-575-7740
Mailing Address - Street 1:1602 ROCK PRAIRIE RD
Mailing Address - Street 2:2200
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8306
Mailing Address - Country:US
Mailing Address - Phone:979-693-7236
Mailing Address - Fax:979-697-7843
Practice Address - Street 1:1602 ROCK PRAIRIE RD
Practice Address - Street 2:SUITE 2200
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8306
Practice Address - Country:US
Practice Address - Phone:979-693-7236
Practice Address - Fax:979-697-7843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty