Organization
INTEGRATED MEDICAL PROFESSIONALS 1, LTD
Active
Other names
IMP 1, Ltd
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHERI HUMPHREYS (ADMINISTRATOR)
(817) 927-8900
Entity
Organization
Contact information
Practice address
2120 MISTLETOE BLVD UNIT 2, FORT WORTH, TX 76110-1174
(817) 927-8900
(817) 927-8902
Mailing address
2120 MISTLETOE BLVD UNIT 2, FORT WORTH, TX 76110-1174
(817) 927-8900
(817) 927-8902
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00185Y
MEDICARE
TX
Enumeration date
07/23/2006
Last updated
03/10/2011
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