Provider Demographics
NPI:1245719053
Name:INTEGRATIVE MEDICAL HOME CARE PLLC
Entity type:Organization
Organization Name:INTEGRATIVE MEDICAL HOME CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-906-0168
Mailing Address - Street 1:1000 HERITAGE CENTER CIR STE 122
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4463
Mailing Address - Country:US
Mailing Address - Phone:512-906-0168
Mailing Address - Fax:512-906-0158
Practice Address - Street 1:1000 HERITAGE CENTER CIR STE 122
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4463
Practice Address - Country:US
Practice Address - Phone:512-906-0168
Practice Address - Fax:512-906-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty