Basic Information
| Provider Information | |||||||||
| NPI: | 1104868975 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INPATIENT MEDICAL SERVICES, P.A. | ||||||||
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| OtherOrganizationName: | INTERCEDE HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 CRAWFORD ST | ||||||||
| Address2: | SUITE 1350 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770029008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8324763900 | ||||||||
| FaxNumber: | 8324766494 | ||||||||
| Practice Location | |||||||||
| Address1: | 3315 BURKE RD | ||||||||
| Address2: | #301 | ||||||||
| City: | PASADENA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775041803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7139410809 | ||||||||
| FaxNumber: | 8324766494 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 04/28/2017 | ||||||||
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| AuthorizedOfficialLastName: | PERMETTI | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8324763900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 006694600 | 05 | FL | MEDICAID | 0808404-01 | 05 | TX | MEDICAID |