Organization
INTEGRATED MEDICAL PROFESSIONALS 1, LTD
Active
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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