Provider Demographics
NPI:1396797577
Name:CEDAR NILES INTERNAL MEDICINE, P.A.
Entity type:Organization
Organization Name:CEDAR NILES INTERNAL MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-619-1770
Mailing Address - Street 1:6053 MAIN ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2062
Mailing Address - Country:US
Mailing Address - Phone:214-619-1770
Mailing Address - Fax:
Practice Address - Street 1:6053 MAIN ST
Practice Address - Street 2:SUITE 230
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2062
Practice Address - Country:US
Practice Address - Phone:214-619-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W233Medicare ID - Type Unspecified