Provider Demographics
NPI:1477806594
Name:INTEGRATED CARE PA
Entity Type:Organization
Organization Name:INTEGRATED CARE PA
Other - Org Name:INTEGRATED PAIN RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DVM
Authorized Official - Phone:940-566-3599
Mailing Address - Street 1:400 N LOOP 288
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-4809
Mailing Address - Country:US
Mailing Address - Phone:940-566-3599
Mailing Address - Fax:866-929-0361
Practice Address - Street 1:400 N LOOP 288
Practice Address - Street 2:SUITE 120
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-4809
Practice Address - Country:US
Practice Address - Phone:940-566-3599
Practice Address - Fax:866-929-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3183204C00000X
TXPA02285363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty