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General NPI Number Information
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NPI Number | 1356781686
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Entity Type | Organization
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Legal Business Name | VIRTUAL INTEGRITY ADVOCATES
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 07/01/2013
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Provider Practice Location Address
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Address Line | 1732 GALLERIA OAKS DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4649
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Country | US
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Telephone | 903-794-1636
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Fax |
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Provider Business Mailing Address
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Address Line | 1732 GALLERIA OAKS DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4649
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Country | US
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Telephone | 903-794-1636
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Fax |
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Authorized Official
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Title or Position | CHEIF MEDICAL OFFICER
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Name | DR. ROBERT STRAYHAN
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Credential | M.D.
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Telephone | 903-794-1636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | E-5611
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | J5027
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License Number State | TX
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