Organization Active NPI

Integrative Medical of DFW LLC

  • Family Medicine Physician
  • Coppell, TX
National Provider Identifier
1760010201
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
INTEGRATIVE MEDICAL OF DFW LLC
Practice address
670 N Macarthur Blvd Ste 100
Coppell, TX 75019-2733
Phone
(972) 745-4446
NPI assigned
Mar 30, 2020
Reactivated
Feb 26, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Dr. Derek Frye, DCNPI 1497060081
Title
Owner
Phone
(972) 358-6526

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

670 N Macarthur Blvd Ste 100
Coppell, TX 75019-2733

Mailing address

670 N Macarthur Blvd Ste 100
Coppell, TX 75019-2733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220819000184 TX Part B Supplier - Clinic/Group Practice 8628451911 Receives reassigned benefits from 4 practitioners
Practice locations: Coppell, TX

National Provider Directory

National Provider Directory

Locations

1364 Southeast Pkwy
Azle, TX 76020
Phone (817) 406-3259

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1760010201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N MACARTHUR BLVD STE 100",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N MACARTHUR BLVD STE 100",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750192733",
            "telephone_number": "972-745-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICAL OF DFW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2026-02-26",
        "certification_date": "2022-07-08",
        "deactivation_date": "2026-02-20",
        "reactivation_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "FRYE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-358-6526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

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