| Intellimedicine, Pa | |
|
154 North Festival Drive, Villa F El Paso TX 79912-6184 | |
| (915) 532-5858 | |
| (915) 532-5859 |
| Full Name | Intellimedicine, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 154 North Festival Drive, Villa F, El Paso, Texas |
| Authorized Official Name and Position | Roxanne Tyroch (PHYSICIAN/OWNER) |
| Authorized Official Contact | 9155325858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intellimedicine, Pa 5823 N Mesa St # 537 El Paso TX 79912-4607 Ph: (915) 261-4377 | Intellimedicine, Pa 154 North Festival Drive, Villa F El Paso TX 79912-6184 Ph: (915) 532-5858 |
| NPI Number | 1134545924 |
|---|---|
| Provider Enumeration Date | 03/17/2014 |
| Last Update Date | 04/18/2024 |
| Medicare PECOS PAC ID | 7517182074 |
|---|---|
| Medicare Enrollment ID | O20140626000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134545924 | NPI | - | NPPES |
| K1945 | Other | TX | TX MED LIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K1945 (Texas) | Primary |
| Provider Name | Roxanne Tyroch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972571743 PECOS PAC ID: 6103871769 Enrollment ID: I20050316000528 |
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