| Intire Health Physician Group | |
|
517 N Carrier Pkwy Grand Prairie TX 75050-5484 | |
| (469) 251-1734 | |
| Not Available |
| Full Name | Intire Health Physician Group |
|---|---|
| Speciality | Pain Medicine |
| Location | 517 N Carrier Pkwy, Grand Prairie, Texas |
| Authorized Official Name and Position | Miguel Del Bosque (OWNER) |
| Authorized Official Contact | 4692511734 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intire Health Physician Group 517 N Carrier Pkwy Grand Prairie TX 75050-5484 Ph: (469) 251-1734 | Intire Health Physician Group 517 N Carrier Pkwy Grand Prairie TX 75050-5484 Ph: (469) 251-1734 |
| NPI Number | 1467037465 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 03/11/2021 |
| Medicare PECOS PAC ID | 4385043173 |
|---|---|
| Medicare Enrollment ID | O20210527001575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467037465 | NPI | - | NPPES |
| Provider Name | Annette H Bamberger Perkins |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1700832284 PECOS PAC ID: 5092711515 Enrollment ID: I20061005000587 |
| Provider Name | Myiesha D.n. Taylor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104990712 PECOS PAC ID: 4587692454 Enrollment ID: I20090512000464 |
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