| Integrated Infectious Diseases, Pllc | |
|
2604 St. Michael Drive Suite 310 Texarkana TX 75503 | |
| (903) 614-5001 | |
| (903) 614-5077 |
| Full Name | Integrated Infectious Diseases, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2604 St. Michael Drive, Texarkana, Texas |
| Authorized Official Name and Position | Charles C Mbonu (PRESIDENT) |
| Authorized Official Contact | 9036145050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Infectious Diseases, Pllc P.o. Box 7707 Texarkana TX 75505 Ph: (903) 614-5001 | Integrated Infectious Diseases, Pllc 2604 St. Michael Drive Suite 310 Texarkana TX 75503 Ph: (903) 614-5001 |
| NPI Number | 1376773168 |
|---|---|
| Provider Enumeration Date | 07/15/2009 |
| Last Update Date | 12/03/2014 |
| Medicare PECOS PAC ID | 3274687355 |
|---|---|
| Medicare Enrollment ID | O20090825000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376773168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Charles Mbonu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033187299 PECOS PAC ID: 6204824741 Enrollment ID: I20090825000280 |
| Provider Name | Cody Ray Copeland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689319675 PECOS PAC ID: 0648656819 Enrollment ID: I20220927000139 |
Express Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5483 Summerhill Rd, Texarkana, TX 75503 Phone: 903-223-5931 Fax: 903-223-5930 | |
Genesis Primecare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1400 College Dr, Texarkana, TX 75503 Phone: 903-791-1110 Fax: 903-791-9353 | |
Genesisprimecare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 College Dr, Texarkana, TX 75503 Phone: 903-791-1110 Fax: 903-791-9353 | |
Trimuph Internal Medicine Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4082 Summerhill Sq, Texarkana, TX 75503 Phone: 903-793-7994 Fax: 903-793-7996 | |
Hygeia At Delphi Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6714 Lawson Cir, Texarkana, TX 75503 Phone: 903-556-9317 | |
Nathan J Wright Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2014 Galleria Oaks Dr, Texarkana, TX 75503 Phone: 903-792-2991 Fax: 903-793-7996 | |
Ranga Balasekaran Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 Texas Blvd Ste 401, Texarkana, TX 75501 Phone: 903-792-4146 Fax: 903-792-0586 |