Provider Demographics
NPI:1487957049
Name:INTEGRITY FAMILY MEDICAL PRACTICE
Entity type:Organization
Organization Name:INTEGRITY FAMILY MEDICAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:EASTER
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:915-562-4246
Mailing Address - Street 1:2931 MONTANA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2409
Mailing Address - Country:US
Mailing Address - Phone:915-562-4246
Mailing Address - Fax:915-564-0667
Practice Address - Street 1:2931 MONTANA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2409
Practice Address - Country:US
Practice Address - Phone:915-562-4246
Practice Address - Fax:915-564-0667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty