GEORGETOWN PULMONARY ASSOCIATES P.A. NPI 1639300288

NPI Information

NPI: 1639300288
Provider Name: GEORGETOWN PULMONARY ASSOCIATES, P.A.
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

CLIA Number: 45D2079008

Address:
1900 SCENIC DRIVE
SUITE 2208
GEORGETOWN, TX
ZIP 78626
Phone: (512) 819-0132
Get Directions

GEORGETOWN PULMONARY ASSOCIATES, P.A. is a pulmonary disease internal medicine in Georgetown, TX. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. GEORGETOWN PULMONARY ASSOCIATES, P.A. NPI is 1639300288. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1900 SCENIC DRIVE
SUITE 2208
GEORGETOWN, TX
ZIP 78626-703
Phone: (512) 819-0132
Fax: (512) 819-9335

The provider's authorized official is Dominic R Dekeratry .
The authorized official title is President and has the following contact phone number (512) 819-0132.

The CLIA number assigned to this NPI record is 45D2079008 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2009 and was last updated on 10/29/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0200X	Internal Medicine	Critical Care Medicine	L0787	TEXAS	No
2	207RP1001X	Internal Medicine	Pulmonary Disease	L0787	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2064198-01	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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