Organization Active NPI

Garland Integrated Healthcare PLLC

  • Adult Medicine Physician
  • Garland, TX
National Provider Identifier
1083082481
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
GARLAND INTEGRATED HEALTHCARE PLLC
Practice address
4702 Northwest Hwy
Garland, TX 75043-5284
Phone
(972) 686-2701
Fax
(972) 686-7496
NPI assigned
Sep 2, 2015
Last updated
Sep 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Authorized official

Name
Dr. Jason Kouri, M.D.NPI 1649276965
Title
President/Ceo
Phone
(972) 686-2701

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Adult Health Nurse Practitioner 363LA2200X
Adult Medicine Physician 207QA0505X Primary

Addresses

Primary practice location

4702 Northwest Hwy
Garland, TX 75043-5284

Mailing address

4702 Northwest Hwy
Garland, TX 75043-5284
Phone (972) 686-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160307002306 TX Part B Supplier - Clinic/Group Practice 9335445071 Receives reassigned benefits from 3 practitioners
Practice locations: Garland, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2106742Garland Integrated Healthcare LLC4702 Northwest Hwy, Garland, TX 75043Certificate of waiverDec 27, 2027

National Provider Directory

National Provider Directory

Locations

1138 Belt Line Rd
Ste 135
Garland, TX 75040
Phone (469) 969-0426

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1083082481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 NORTHWEST HWY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435284",
            "telephone_number": "972-686-2701",
            "fax_number": "972-270-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 NORTHWEST HWY",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750435284",
            "telephone_number": "972-686-2701",
            "fax_number": "972-686-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARLAND INTEGRATED HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "KOURI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-686-2701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.