| Azalea Internal Medicine Associates Pa | |
|
1100 E Lake St Tyler TX 75701-3343 | |
| (903) 509-4100 | |
| Not Available |
| Full Name | Azalea Internal Medicine Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1100 E Lake St, Tyler, Texas |
| Authorized Official Name and Position | Neil H Adelman (PRESIDENT, SOLE MEMBER) |
| Authorized Official Contact | 9035094100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azalea Internal Medicine Associates Pa Po Box 6367 Tyler TX 75711-6367 Ph: () - | Azalea Internal Medicine Associates Pa 1100 E Lake St Tyler TX 75701-3343 Ph: (903) 509-4100 |
| NPI Number | 1366738908 |
|---|---|
| Provider Enumeration Date | 06/22/2011 |
| Last Update Date | 06/22/2011 |
| Medicare PECOS PAC ID | 5991983744 |
|---|---|
| Medicare Enrollment ID | O20110624000436 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366738908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | J8194 (Texas) | Primary |
| Provider Name | Neil H Adelman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902848120 PECOS PAC ID: 4284636200 Enrollment ID: I20070205000280 |
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