Organization
ASSOCIATES OF INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAVANI BELLARY D.O. (PHYSICIAN, OWNER)
(682) 268-1152
Entity
Organization
Contact information
Practice address
2260 COLLEGE AVE, FORT WORTH, TX 76110-1952
(682) 268-1152
(877) 772-0063
Mailing address
PO BOX 12056, FORT WORTH, TX 76110-8056
(682) 268-1152
(817) 818-1766
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L8281
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1765463
—
TX
Enumeration date
02/28/2007
Last updated
09/17/2020
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