Provider Demographics
NPI:1558573485
Name:INFORMED CARE SOLUTIONS, INC
Entity Type:Organization
Organization Name:INFORMED CARE SOLUTIONS, INC
Other - Org Name:INFORMED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-823-4222
Mailing Address - Street 1:PO BOX 6250
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-6250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 E SAUNDERS ST
Practice Address - Street 2:AUITE 690
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5443
Practice Address - Country:US
Practice Address - Phone:877-794-8856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0301208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0053NLOtherBCBS GROUP NUMBER
TX00595YMedicare ID - Type UnspecifiedGROUP NUMBER