Provider Demographics
NPI:1083082481
Name:GARLAND INTEGRATED HEALTHCARE PLLC
Entity Type:Organization
Organization Name:GARLAND INTEGRATED HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:KOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-686-2701
Mailing Address - Street 1:4702 NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5284
Mailing Address - Country:US
Mailing Address - Phone:972-686-2701
Mailing Address - Fax:972-270-5335
Practice Address - Street 1:4702 NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5284
Practice Address - Country:US
Practice Address - Phone:972-686-2701
Practice Address - Fax:972-686-7496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX478003Medicare PIN
TX7485710001Medicare NSC