Integrated Health-Rehab, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

Q2071 Issued in TX

Legal business name

INTEGRATED HEALTH-REHAB, LLC

Practice address

500 Flower Mound Rd SPC 104
Flower Mound, TX 75028-3418

Phone

(915) 329-8764

Fax

(915) 329-8764

NPI assigned

Sep 13, 2017

Last updated

Sep 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jorge Luis Nieto

Title

Owner

Phone

(915) 329-8764

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505865600000",
    "number": "1518486372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FLOWER MOUND RD SPC 104",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283418",
            "telephone_number": "915-329-8764",
            "fax_number": "214-285-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FLOWER MOUND RD SPC 104",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283418",
            "telephone_number": "915-329-8764",
            "fax_number": "915-329-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTH-REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-20",
        "status": "A",
        "authorized_official_last_name": "NIETO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-329-8764"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "Q2071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.