Provider Demographics
NPI:1750570768
Name:INTERNAL & PULMONARY CLINIC
Entity type:Organization
Organization Name:INTERNAL & PULMONARY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:CLAUDIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:956-605-6062
Mailing Address - Street 1:213 E SANTA ROSA
Mailing Address - Street 2:
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78538
Mailing Address - Country:US
Mailing Address - Phone:214-321-4210
Mailing Address - Fax:888-900-4512
Practice Address - Street 1:8035 E RL THRTN FWY
Practice Address - Street 2:233
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:214-321-4210
Practice Address - Fax:888-900-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081315601Medicaid
TX00881NMedicare PIN
TXB21883Medicare UPIN