NPIMap

Organization Active NPI

Integrated Medical Practice PA

  • Pain Medicine Physician
  • Carrollton, TX
National Provider Identifier
1750659322
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
INTEGRATED MEDICAL PRACTICE PA
Practice address
2710 N Josey LN
Suite 301
Carrollton, TX 75007-5400
Phone
(214) 483-3550
NPI assigned
Dec 9, 2011
Last updated
Dec 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Authorized official

Name
Jerry Holubec, DO
Title
President
Phone
(972) 479-1115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X Primary

Addresses

Primary practice location

2710 N Josey LN
Suite 301
Carrollton, TX 75007-5400

Mailing address

PO Box 269083
Oklahoma City, OK 73126-9083

National Provider Directory

National Provider Directory
Tax ID family
Integrated Medical Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1750659322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269083",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 N JOSEY LN",
            "address_2": "SUITE 301",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750075400",
            "telephone_number": "214-483-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "HOLUBEC",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-479-1115",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.