MEDICARE: INTEGRATED FAMILY HEALTHCARE, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	589114	TX

General Provider Information

NPI Number	:	1487687158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED FAMILY HEALTHCARE, PC

Provider Business Mailing Address
First Line	:	6080 S HULEN ST
Second Line	:	STE. 360
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2622
Country	:	US
Telephone Number	:	817-903-8383
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 SOUTH FWY
Second Line	:	SUITE 428
City	:	FORT WORTH
State	:	TX
Zip	:	76115-1400
Country	:	US
Telephone Number	:	817-903-8383
Fax Number	:	817-346-7006

Authorized Official
Title or Position	:	OWNER
Name	:	MS. INGRID CORA HINOJOSA
Credential	:	NURSE PRACTITIONER
Telephone Number	:	817-903-8383

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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