Provider Demographics
NPI:1386705648
Name:HALE COUNTY INTERNAL MEDICINE
Entity type:Organization
Organization Name:HALE COUNTY INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-291-3302
Mailing Address - Street 1:2508 XENIA ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-1818
Mailing Address - Country:US
Mailing Address - Phone:806-291-3302
Mailing Address - Fax:806-291-3305
Practice Address - Street 1:2508 XENIA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-1818
Practice Address - Country:US
Practice Address - Phone:806-291-3302
Practice Address - Fax:806-291-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID NUMBER