Organization
INTEGRATED INFECTIOUS DISEASES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES C MBONU MD (PRESIDENT)
(903) 614-5050
Entity
Organization
Contact information
Practice address
2604 ST. MICHAEL DRIVE, SUITE 310, TEXARKANA, TX 75503
(903) 614-5001
(903) 614-5077
Mailing address
P.O. BOX 7707, TEXARKANA, TX 75505
(903) 614-5001
(903) 614-5077
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
07/15/2009
Last updated
12/03/2014
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