Corporate-Industry Medical Group

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

CORPORATE-INDUSTRY MEDICAL GROUP

Practice address

4425 W Airport Fwy
Suite 305
Irving, TX 75062-5832

Phone

(972) 570-8200

Fax

(972) 570-8933

NPI assigned

May 18, 2007

Last updated

Apr 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. George F Heath, CLU

Title

Ceo

Phone

(972) 570-8200

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1174731517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 W AIRPORT FWY",
            "address_2": "SUITE 305",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625832",
            "telephone_number": "972-570-8200",
            "fax_number": "972-570-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 W AIRPORT FWY",
            "address_2": "SUITE 305",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625832",
            "telephone_number": "972-570-8200",
            "fax_number": "972-570-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPORATE-INDUSTRY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "HEATH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-570-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CLU"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Irving, TX
• Providers in Irving, TX by specialty
• Clinical Neuropsychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.