Provider Demographics
NPI:1982998332
Name:HOUSTON INTERNAL MEDICINE ASSOCIATES PA
Entity type:Organization
Organization Name:HOUSTON INTERNAL MEDICINE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIJAYSHEKAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:ELATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-809-0085
Mailing Address - Street 1:21336 PROVINCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:832-516-5618
Practice Address - Street 1:21336 PROVINCIAL BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7580
Practice Address - Country:US
Practice Address - Phone:281-809-0085
Practice Address - Fax:832-516-6184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2066207R00000X
TXN5355207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID