Provider Demographics
NPI:1871547026
Name:INTERNAL MEDICINE CONSULTANTS LLC
Entity type:Organization
Organization Name:INTERNAL MEDICINE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:FEBRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-456-9199
Mailing Address - Street 1:PO BOX 733576
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3576
Mailing Address - Country:US
Mailing Address - Phone:504-517-5551
Mailing Address - Fax:504-456-9602
Practice Address - Street 1:3941 HOUMA BLVD STE 2B
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2920
Practice Address - Country:US
Practice Address - Phone:504-456-9199
Practice Address - Fax:504-456-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1445240Medicaid
LA5CG27OtherMEDICARE PTAN
DA4228OtherMEDICARE RAILROAD