Provider Demographics
NPI:1770931586
Name:TEXAS INPATIENT MEDICINE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:TEXAS INPATIENT MEDICINE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALBOT
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCCORMICK, III
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-441-8556
Mailing Address - Street 1:5901-C PEACHTREE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-7159
Mailing Address - Country:US
Mailing Address - Phone:678-441-8556
Mailing Address - Fax:678-441-8656
Practice Address - Street 1:5901-C PEACHTREE DUNWOODY ROAD
Practice Address - Street 2:SUITE 350
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-7159
Practice Address - Country:US
Practice Address - Phone:678-441-8556
Practice Address - Fax:678-441-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty