Provider Demographics
NPI:1669218244
Name:INTEGRAL HEALTH CLINIC LLC
Entity type:Organization
Organization Name:INTEGRAL HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:REBUGIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-605-3399
Mailing Address - Street 1:3913 ALVARADO ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-0281
Mailing Address - Country:US
Mailing Address - Phone:210-605-3399
Mailing Address - Fax:
Practice Address - Street 1:3913 ALVARADO ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-0281
Practice Address - Country:US
Practice Address - Phone:210-605-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty