| Img Medical Group Tx, P.a. | |
|
325 N Saint Paul St Ste 3100 Dallas TX 75201-3923 | |
| (888) 760-4266 | |
| Not Available |
| Full Name | Img Medical Group Tx, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 325 N Saint Paul St Ste 3100, Dallas, Texas |
| Authorized Official Name and Position | Robert Refowitz (PRESIDENT) |
| Authorized Official Contact | 8887604266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Img Medical Group Tx, P.a. 201 Broad St Ste 420 Stamford CT 06901-2004 Ph: () - | Img Medical Group Tx, P.a. 325 N Saint Paul St Ste 3100 Dallas TX 75201-3923 Ph: (888) 760-4266 |
| NPI Number | 1619659760 |
|---|---|
| Provider Enumeration Date | 08/07/2023 |
| Last Update Date | 06/28/2024 |
| Medicare PECOS PAC ID | 5799138210 |
|---|---|
| Medicare Enrollment ID | O20240131001670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619659760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Jasper Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700205846 PECOS PAC ID: 4082987318 Enrollment ID: I20240131002324 |
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