Organization
INTEGRATIVE PHYSICAL MEDICINE AND REHABILITATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE AHN (PRESIDENT)
(972) 201-7988
Entity
Organization
Contact information
Practice address
2246 ASH GROVE WAY, DALLAS, TX 75228-5385
(972) 201-7988
(972) 201-7988
Mailing address
PO BOX 570492, DALLAS, TX 75357-0492
(972) 201-7988
(972) 201-7988
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
M6489
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6437750001
MEDICARE NSC
TX
Enumeration date
06/28/2007
Last updated
03/27/2014
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