Organization
HERITAGE INTER-MED, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CECIL CEDRIC BAILEY MD (OWNER)
(972) 299-0003
Entity
Organization
Contact information
Practice address
1121 N JOE WILSON RD, CEDAR HILL, TX 75104-1430
(972) 299-0003
(972) 299-0004
Mailing address
1121 N JOE WILSON RD, CEDAR HILL, TX 75104-1430
(972) 299-0003
(972) 299-0004
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158180352
SECURE HORIZONS
TX
05
—
203079301
—
TX
01
—
392541
WELLCARE
TX
01
—
7809231
AETNA
TX
01
—
DQ8950
RAILROAD MEDICARE
TX
Enumeration date
04/24/2007
Last updated
01/27/2017
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