Organization Active NPI

Internal Medicine & Geriatrics of Houston, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Warner Robins, GA
National Provider Identifier
1730385402
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
047430 Issued in GA
Legal business name
INTERNAL MEDICINE & GERIATRICS OF HOUSTON, LLC
Practice address
1743 Watson Blvd
Suite a
Warner Robins, GA 31093-3633
Phone
(478) 328-9690
Fax
(478) 328-9692
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Fabian R. Franco, MDNPI 1649237207
Title
Owner
Phone
(478) 328-9690

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
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 047430 GA Primary

Addresses

Primary practice location

1743 Watson Blvd
Suite a
Warner Robins, GA 31093-3633

Mailing address

1743 Watson Blvd
Suite a
Warner Robins, GA 31093-3622
Phone (478) 328-9690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070803000232 GA Part B Supplier - Clinic/Group Practice 0648361758 Receives reassigned benefits from 3 practitioners
Practice locations: Bonaire, GA

National Provider Directory

National Provider Directory

Locations

201 Stillwater Cir
Bonaire, GA 31005
Phone (478) 328-9690

1743 Watson Blvd
Ste A
Warner Robins, GA 31093
Phone (478) 328-9690

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1730385402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 WATSON BLVD",
            "address_2": "SUITE A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933622",
            "telephone_number": "478-328-9690",
            "fax_number": "478-328-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 WATSON BLVD",
            "address_2": "SUITE A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933633",
            "telephone_number": "478-328-9690",
            "fax_number": "478-328-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE & GERIATRICS OF HOUSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "FRANCO",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-328-9690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "047430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.