Img Clinic PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IMG CLINIC PLLC

Practice address

11924 Vance Jackson Rd Ste 104
San Antonio, TX 78230-1459

Phone

(313) 314-0617

NPI assigned

Feb 17, 2022

Last updated

Feb 17, 2022By 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

Michael McMahan, MD

Title

Medical Director

Phone

(405) 760-2018

Specialties & licenses 1

Addresses

Tax ID family

Img Clinic PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Img Clinic PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Savoy, IL
  • NPI 1144975137
  NPD tax ID
• Img Clinic PLLC

  • Internal Medicine Physician
  • Greenville, SC
  • NPI 1609521681
  NPD tax ID
• Img Clinic PLLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1851048623
  NPD tax ID

Locations

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.

• Herbert Richard Slavin, MD

  • Internal Medicine Physician
  • Lauderhill, FL
  • NPI 1528018512
  NPD (past)

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1386399368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W 11TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843150",
            "telephone_number": "313-314-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11924 VANCE JACKSON RD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301459",
            "telephone_number": "313-314-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMG CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "MCMAHAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "405-760-2018",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haidar Imam, DDS
• Mohamed Imam, DDS
• Erin Imburgia
• Imed Healthcare Associates, PLLC (IMED Internal Medicine)
• Imed Internal Medicine PA
• Imk Healthcare LLC
• Tamara Elizabeth Imken-Betz
• Lauren M Immenschuh, MA, BCBA
• Immuno D, Inc.
• Immuno, PA

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.