Provider Demographics
NPI:1487687158
Name:INTEGRATED FAMILY HEALTHCARE, PC
Entity Type:Organization
Organization Name:INTEGRATED FAMILY HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:CORA
Authorized Official - Last Name:HINOJOSA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:817-903-8383
Mailing Address - Street 1:6080 S HULEN ST
Mailing Address - Street 2:STE. 360
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2622
Mailing Address - Country:US
Mailing Address - Phone:817-903-8383
Mailing Address - Fax:
Practice Address - Street 1:4200 SOUTH FWY
Practice Address - Street 2:SUITE 428
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1400
Practice Address - Country:US
Practice Address - Phone:817-903-8383
Practice Address - Fax:817-346-7006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXY13883Medicare UPIN
TX00088XMedicare ID - Type Unspecified