Diagnostic & Internal Medicine Clinic PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

69255 Issued in TX

Legal business name

DIAGNOSTIC & INTERNAL MEDICINE CLINIC PA

Practice address

2929 Calder Street
Suite 308
Beaumont, TX 77702

Phone

(409) 833-2929

Fax

(409) 839-8355

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

George V Zuzukin, MD

Title

President Owner

Phone

(409) 833-2929

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992879068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 CALDER STREET",
            "address_2": "SUITE 308",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-833-2929",
            "fax_number": "409-839-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 CALDER STREET",
            "address_2": "SUITE 308",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77702",
            "telephone_number": "409-833-2929",
            "fax_number": "409-839-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC & INTERNAL MEDICINE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZUZUKIN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "409-833-2929",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "69255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8J3606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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