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General NPI Number Information
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NPI Number | 1780902502
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH CENTER, PA
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 6617 HERITAGE PKWY SUITE 100
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City | ROCKWALL
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State | TX
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Zip | 75087-8750
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Country | US
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Telephone | 972-412-7555
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Fax | 972-412-7558
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Provider Business Mailing Address
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Address Line | 6617 HERITAGE PKWY SUITE 100
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City | ROCKWALL
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State | TX
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Zip | 75087-8750
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Country | US
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Telephone | 972-412-7555
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Fax | 972-412-7558
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBERT SUTHERLAND
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Credential | M.D.
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Telephone | 972-414-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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