Provider Demographics
NPI:1447459979
Name:ISERN RHEUMATOLOGY CLINIC, PA
Entity type:Organization
Organization Name:ISERN RHEUMATOLOGY CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-860-0599
Mailing Address - Street 1:3350 DOWLEN RD STE E
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7263
Mailing Address - Country:US
Mailing Address - Phone:409-860-0599
Mailing Address - Fax:409-861-0301
Practice Address - Street 1:3350 DOWLEN RD STE E
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7263
Practice Address - Country:US
Practice Address - Phone:409-860-0599
Practice Address - Fax:409-861-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-14
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty