Organization Active NPI

Integrative Medical Care PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • College Station, TX
National Provider Identifier
1073201547
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
INTEGRATIVE MEDICAL CARE PLLC
Practice address
2700 Earl Rudder Fwy S Ste 2100
College Station, TX 77845-5038
Phone
(979) 221-2610
NPI assigned
Apr 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandi MoralesNPI 1548841299
Title
Family Nurse Practitioner
Phone
(979) 221-2610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

2700 Earl Rudder Fwy S Ste 2100
College Station, TX 77845-5038

Mailing address

2700 Earl Rudder Fwy S Ste 2100
College Station, TX 77845-5038
Phone (979) 221-2610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240821004194 TX Part B Supplier - Clinic/Group Practice 6709324791 Receives reassigned benefits from 2 practitioners
Practice locations: College Station, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1073201547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 EARL RUDDER FWY S STE 2100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455038",
            "telephone_number": "979-221-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 EARL RUDDER FWY S STE 2100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455038",
            "telephone_number": "979-221-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "979-221-2610"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.