Individual
BENSON IGBOELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
829 SPRINGWOOD DR, GRAND PRAIRIE, TX 75052-6092
(972) 262-5828
(972) 262-5828
Mailing address
829 SPRINGWOOD DR, GRAND PRAIRIE, TX 75052-6092
(972) 262-5828
(972) 262-5828
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
000000000000
TX
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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