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General NPI Number Information
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NPI Number | 1235075508
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE FAMILY CARE LLC
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 2305 WOODTHRUSH RD
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City | PONCA CITY
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State | OK
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Zip | 74604-2830
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Country | US
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Telephone | 405-757-9781
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Fax |
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Provider Business Mailing Address
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Address Line | 2305 WOODTHRUSH RD
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City | PONCA CITY
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State | OK
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Zip | 74604-2830
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Country | US
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Telephone | 405-757-9781
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/OWNER
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Name | TAYLOR G LEWIS
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Credential | APRN
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Telephone | 405-757-9781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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