# WACO INTEGRATED MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205397965
- **Authorized official:** PHILIP FULTON (BILLING MANAGER)
- **Authorized official phone:** (254) 581-0247

## Contact information

- **Practice address:** 8300 OLD MCGREGOR RD STE 2A, WOODWAY, TX 76712-3600
- **Practice address phone:** (254) 537-1064
- **Practice address fax:** (254) 537-1092
- **Mailing address:** 5000 W WACO DR, WACO, TX 76710-7022
- **Mailing address phone:** (254) 537-1064
- **Mailing address fax:** (254) 537-1092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2019
- **Last updated:** 05/26/2026