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INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA NPI 1205023397


NPI Information

NPI: 1205023397
Provider Name: INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 45D1077699

Address:
4305 W WHEATLAND RD
SUITE NUMBER 101
DALLAS, TX
ZIP 75237
Phone: (214) 697-7985
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INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA is an internal medicine in Dallas, TX. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. INTERNAL MEDICINE ASSOCIATES OF SOUTH DALLAS PA NPI is 1205023397. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4305 W WHEATLAND RD
SUITE NUMBER 101
DALLAS, TX
ZIP 75237-303
Phone: (214) 697-7985
Fax: (972) 708-9498

The provider's authorized official is Ashwani Dayal Srivastava .
The authorized official title is President and has the following contact phone number (214) 697-7985.

The CLIA number assigned to this NPI record is 45D1077699 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2007 and was last updated on 10/28/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineL3488TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100Y545MEDICARE PINTEXAS
20047QWOTHERTEXASBCBS
31467507038OTHERINDIVIDUAL NPI NUMBER
4150972102MEDICAIDTEXAS
58714B6MEDICARE PINTEXAS
6191673601MEDICAIDTEXAS
7DG8307MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.