Provider Demographics
NPI:1528191517
Name:INTEGRATED REHABILITATION SYSTEMS INC
Entity Type:Organization
Organization Name:INTEGRATED REHABILITATION SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:STRADER
Authorized Official - Suffix:
Authorized Official - Credentials:PROFESSIONAL ENGINEE
Authorized Official - Phone:972-313-0186
Mailing Address - Street 1:1128 LUKE ST
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-4004
Mailing Address - Country:US
Mailing Address - Phone:972-313-0186
Mailing Address - Fax:972-986-9093
Practice Address - Street 1:1128 LUKE ST
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4004
Practice Address - Country:US
Practice Address - Phone:972-313-0186
Practice Address - Fax:972-986-9093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology SupplierGroup - Multi-Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX530711OtherBCBSTX
TX1098840001Medicare ID - Type Unspecified