Organization
INTERNAL MEDICINE & NEPHROLOGY ASSOCIATES, PA
Active
Other names
West Park Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA KNOEDLER BS (CLINIC ADMINISTRATOR)
(936) 328-5820
Entity
Organization
Contact information
Practice address
210 W PARK STE 104, LIVINGSTON, TX 77351-8337
(936) 328-5820
(936) 328-5824
Mailing address
210 W PARK STE 104, LIVINGSTON, TX 77351-8337
(936) 328-5820
(936) 328-5824
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0096NC
BCBS TX
TX
05
—
176014201
—
TX
01
—
DD5409
RAILROAD MEDICARE GROUP #
TX
01
—
P00234310
RAILROAD MEDICARE PIN
TX
Enumeration date
03/20/2007
Last updated
11/26/2024
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