Healthcare Provider Details

I. General information

NPI: 1023039187
Provider Name (Legal Business Name): INTEGRIS AMBULATORY CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SW 34TH ST STE 300
MOORE OK
73160-3059
US

IV. Provider business mailing address

PO BOX 843754
KANSAS CITY MO
64184-3754
US

V. Phone/Fax

Practice location:
  • Phone: 405-793-7885
  • Fax:
Mailing address:
  • Phone: 405-252-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL L WEED
Title or Position: TREASURER
Credential:
Phone: 405-951-2737