Integrative Multidisciplinary Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P8718 Issued in TX

Legal business name

INTEGRATIVE MULTIDISCIPLINARY MEDICAL GROUP

Practice address

670 N Macarthur Blvd
Coppell, TX 75019-2733

Phone

(972) 745-4446

Fax

(972) 745-2597

NPI assigned

May 2, 2017

Organization subpart

No

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

Authorized official

Name

John W East, DO

Title

Owner

Phone

(214) 722-7102

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507852800000",
    "number": "1124554746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N MACARTHUR BLVD",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192733",
            "telephone_number": "972-745-4446",
            "fax_number": "972-745-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N MACARTHUR BLVD",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192733",
            "telephone_number": "972-745-4446",
            "fax_number": "972-745-2597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16633 Dallas Pkwy",
            "address_2": "Ste 125",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750016816",
            "country_code": "US",
            "telephone_number": "972-380-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATIVE MULTIDISCIPLINARY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-10-13",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-722-7102",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P8718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Coppell, TX
• Providers in Coppell, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.