Healthcare Provider Details

I. General information

NPI: 1750154316
Provider Name (Legal Business Name): INTEGRATED PATIENT SOLUTIONS OF ARKANSAS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 17TH ST STE 1000
DENVER CO
80202-2043
US

IV. Provider business mailing address

1125 17TH ST STE 1000
DENVER CO
80202-2043
US

V. Phone/Fax

Practice location:
  • Phone: 980-443-4852
  • Fax: 720-617-8430
Mailing address:
  • Phone: 720-204-5760
  • Fax: 720-617-8430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FARHAD MODARAI
Title or Position: PRESIDENT
Credential: DO
Phone: 980-443-4852