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General NPI Number Information
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NPI Number | 1356162846
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Entity Type | Organization
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Legal Business Name | MD INTEGRATIVE HEALTH PLLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1308 S STATE HIGHWAY 16
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-5058
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Country | US
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Telephone | 830-997-2181
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Fax | 830-997-4453
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Provider Business Mailing Address
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Address Line | 1308 S STATE HIGHWAY 16
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City | FREDERICKSBURG
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State | TX
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Zip | 78624-5058
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Country | US
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Telephone | 830-997-2181
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Fax | 830-997-4453
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDRA GARRED
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Credential | MD
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Telephone | 602-327-3181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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