NPIMap

Organization Active NPI

Azalea Internal Medicine Associates PA

  • Internal Medicine Physician
  • Tyler, TX
National Provider Identifier
1366738908
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J8194 Issued in TX
Legal business name
AZALEA INTERNAL MEDICINE ASSOCIATES PA
Practice address
1100 E Lake St
Tyler, TX 75701-3343
Phone
(903) 509-4100
NPI assigned
Jun 22, 2011
Last updated
Jun 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Authorized official

Name
Neil H Adelman, MDNPI 1902848120
Title
President, Sole Member
Phone
(903) 509-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J8194 TX Primary

Addresses

Primary practice location

1100 E Lake St
Tyler, TX 75701-3343

Mailing address

PO Box 6367
Tyler, TX 75711-6367

National Provider Directory

National Provider Directory

Locations

1100 E Lake St
Ste 170
Tyler, TX 75701
Phone (903) 509-4100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308700800000",
    "number": "1366738908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6367",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757116367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E LAKE ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013343",
            "telephone_number": "903-509-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZALEA INTERNAL MEDICINE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-06-22",
        "status": "A",
        "authorized_official_last_name": "ADELMAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT, SOLE MEMBER",
        "authorized_official_telephone_number": "903-509-4100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J8194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.