NPIMap

Organization Active NPI

Primary Internal Medicine

  • Internal Medicine Physician
  • Sugar Land, TX
National Provider Identifier
1104369776
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M0699 Issued in TX
Legal business name
PRIMARY INTERNAL MEDICINE
Practice address
30 Sierra Oaks Dr
Sugar Land, TX 77479-5899
Phone
(713) 714-2446
Fax
(713) 714-2439
NPI assigned
Nov 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Deepa Dave, M.D
Title
Director
Phone
(713) 714-2446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X M0699 TX Primary

Addresses

Primary practice location

30 Sierra Oaks Dr
Sugar Land, TX 77479-5899

Mailing address

30 Sierra Oaks Dr
Sugar Land, TX 77479-5899
Phone (713) 714-2446

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1104369776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SIERRA OAKS DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774795899",
            "telephone_number": "713-714-2446",
            "fax_number": "713-714-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SIERRA OAKS DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774795899",
            "telephone_number": "713-714-2446",
            "fax_number": "713-714-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "DAVE",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-714-2446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M0699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.