NPIMap

Organization Active NPI

Ideal Internal Medicine PLLC

  • Internal Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1881082121
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L0290 Issued in TX
Legal business name
IDEAL INTERNAL MEDICINE PLLC
Practice address
5920 Saratoga Blvd
Suite 475
Corpus Christi, TX 78414-4103
Phone
(361) 654-2064
Fax
(361) 654-2068
NPI assigned
Jan 8, 2015
Last updated
Jan 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Authorized official

Name
Michele Ibanez, MD
Title
Owner
Phone
(361) 654-2064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L0290 TX Primary

Addresses

Primary practice location

5920 Saratoga Blvd
Suite 475
Corpus Christi, TX 78414-4103

Mailing address

5920 Saratoga Blvd
Suite 475
Corpus Christi, TX 78414-4103
Phone (361) 654-2064

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1881082121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 SARATOGA BLVD",
            "address_2": "SUITE 475",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144103",
            "telephone_number": "361-654-2064",
            "fax_number": "361-654-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 SARATOGA BLVD",
            "address_2": "SUITE 475",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144103",
            "telephone_number": "361-654-2064",
            "fax_number": "361-654-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-654-2064",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L0290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.