Basic Information
| Provider Information | |||||||||
| NPI: | 1083267983 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHWEST INTERNAL MEDICINE AND GERIATRICS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9521 BIG VIEW DR | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787303592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4785508383 | ||||||||
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| Practice Location | |||||||||
| Address1: | 540 E HWY 29 | ||||||||
| Address2: | |||||||||
| City: | BERTRAM | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123552116 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2019 | ||||||||
| LastUpdateDate: | 12/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | SYED | ||||||||
| AuthorizedOfficialFirstName: | ASIF | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4785508383 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.