Integra Health Services Professional Corporation

NPI #1861915415 in Coushatta, Louisiana

Provider Information

NPI Number: 1861915415
Entity Type: Organization
Organization Name: Integra Health Services Professional Corporation
Primary Specialty: Internal Medicine
Enumeration Date: Jul 25, 2017
Last Updated: Mar 17, 2018

Practice Location

Address: 1110 RINGGOLD AVE STE B
City: Coushatta
State: Louisiana
ZIP Code: 71019-9004
Phone: (318) 798-4606

Authorized Official

Name: DR. GAVIN F CHICO, MD
Title: MD/OWNER
Phone: (318) 780-6230

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Long Term Care Hospital	282E00000X
Rehabilitation Hospital	283X00000X
Internal Medicine	207R00000X	Primary

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