Provider Demographics
NPI:1982077426
Name:INTEGRATED THERAPY
Entity Type:Organization
Organization Name:INTEGRATED THERAPY
Other - Org Name:TOTAL INTEGRATED THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATURAL HEALING SOLUTIONS PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MMT, LMT, NCETMB
Authorized Official - Phone:972-249-7331
Mailing Address - Street 1:2908 CLEAR SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7602
Mailing Address - Country:US
Mailing Address - Phone:972-249-7331
Mailing Address - Fax:
Practice Address - Street 1:2908 CLEAR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7602
Practice Address - Country:US
Practice Address - Phone:972-249-7331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2357251S00000X
TXMT101016302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No251S00000XAgenciesCommunity/Behavioral Health