Organization Active NPI

Integrative Physical Medicine and Rehabilitation PA

  • Physical Medicine & Rehabilitation Physician
  • Dallas, TX
National Provider Identifier
1992902415
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
M6489 Issued in TX
Legal business name
INTEGRATIVE PHYSICAL MEDICINE AND REHABILITATION PA
Practice address
2246 Ash Grove Way
Dallas, TX 75228-5385
Phone
(972) 201-7988
Fax
(972) 201-7988
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Authorized official

Name
Lawrence Ahn
Title
President
Phone
(972) 201-7988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X M6489 TX Primary

Addresses

Primary practice location

2246 Ash Grove Way
Dallas, TX 75228-5385

Mailing address

PO Box 570492
Dallas, TX 75357-0492
Phone (972) 201-7988

Other identifiers 1

IdentifierTypeStateIssuer
6437750001OtherTXMEDICARE NSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1992902415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570492",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753570492",
            "telephone_number": "972-201-7988",
            "fax_number": "972-201-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2246 ASH GROVE WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752285385",
            "telephone_number": "972-201-7988",
            "fax_number": "972-201-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE PHYSICAL MEDICINE AND REHABILITATION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-201-7988"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "M6489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "6437750001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.