Provider Demographics
NPI:1841244423
Name:GENERAL INTERNAL MEDICINE, PA
Entity type:Organization
Organization Name:GENERAL INTERNAL MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-375-6262
Mailing Address - Street 1:5710 DELOACHE AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-3001
Mailing Address - Country:US
Mailing Address - Phone:214-375-6262
Mailing Address - Fax:214-375-6266
Practice Address - Street 1:550 E ANN ARBOR AVE
Practice Address - Street 2:RESIDENT AND COMMUNITY RELATIONS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-6718
Practice Address - Country:US
Practice Address - Phone:214-375-6262
Practice Address - Fax:214-375-6266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093817703Medicaid
TX00L10GOtherBCBS
TXCI9602OtherRAILROAD MEDICARE
TX00919YMedicare PIN
TX00L10GMedicare PIN