MEDICARE: TEXAS INTEGRATED HEALTHCARE SOLUTIONS PLLC

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	363L00000X	Nurse Practitioner
2	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1982053898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS INTEGRATED HEALTHCARE SOLUTIONS PLLC

Provider Business Mailing Address
First Line	:	1606 WYNN JOYCE RD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75043-3266
Country	:	US
Telephone Number	:	972-303-0683
Fax Number	:

Provider Business Practice Location Address
First Line	:	7967 CINCINNATI DAYTON RD STE P
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-2064
Country	:	US
Telephone Number	:	513-685-0949
Fax Number	:	513-282-0946

Authorized Official
Title or Position	:	OWNER
Name	:	SHERIF SHAMMA
Credential	:
Telephone Number	:	281-739-6447

Provider Enumeration Date	:	06/10/2016
Last Update Date	:	06/10/2016

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