Imd Healthcare Association, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IMD HEALTHCARE ASSOCIATION, INC.

Practice address

5857 Tory Dr
Grand Prairie, TX 75052-8500

Phone

(817) 522-2296

NPI assigned

Jun 16, 2020

Organization subpart

No

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

Authorized official

Name

CHI VI Le Chau

Title

Officer

Phone

(817) 522-2296

Specialties & licenses 1

Addresses

Other names 1

• 1st Health Family Clinic Doing business as

Locations

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1427673375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 EXECUTIVE CIR STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382522",
            "telephone_number": "817-522-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5857 TORY DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528500",
            "telephone_number": "817-522-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMD HEALTHCARE ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "CHAU",
        "authorized_official_first_name": "CHI VI",
        "authorized_official_middle_name": "LE",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "817-522-2296"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Health Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Grand Prairie, TX
• Providers in Grand Prairie, 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 Jun 16, 2020; 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.