Integrated Infectious Diseases, PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

INTEGRATED INFECTIOUS DISEASES, PLLC

Practice address

1002 Texas Blvd Ste 200
Texarkana, TX 75501-5133

Phone

(903) 310-4950

NPI assigned

Jul 15, 2009

Organization subpart

No

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

Authorized official

Name

Charles C Mbonu, MDNPI 1033187299

Title

President

Phone

(903) 614-5050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Charles Chibundu Mbonu, MD

  • Infectious Disease Physician
  • Texarkana, TX
  • NPI 1033187299
  Medicare reassignment Care Compare group NPD Authorized official
• Cody Ray Copeland, NP-C

  • Family Nurse Practitioner
  • Texarkana, TX
  • NPI 1689319675
  Medicare reassignment Care Compare group NPD
• Colby Rebecca Pair, PA-C

  • Physician Assistant
  • Bullard, TX
  • NPI 1609282433
  NPD (past)

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1376773168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7707",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755057707",
            "telephone_number": "903-310-4950",
            "fax_number": "903-793-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD STE 200",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015133",
            "telephone_number": "903-310-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED INFECTIOUS DISEASES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "MBONU",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-614-5050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Living of Texarkana, LLC
• Independent Senior Living of Texarkana, LLC
• Insight Behavioral Health PLLC
• Integracare of Athens - Hospice, LLC
• Integrated Healthcare L.L.P.
• Lacey Jackson Teer
• Don Jackson, O.D.
• Gary L Jackson, CRNA
• Juliet Noelle Jackson
• Noel R Jackson, CRNA

• Infectious Disease Physician in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.