Individual
DR. IRVIN PETE BROCK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 N SKYLINE DR, FOUNTAIN HILLS, AZ 85268-6182
(210) 792-4192
Mailing address
10833 N SKYLINE DR, FOUNTAIN HILLS, AZ 85268-6182
(210) 792-4192
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
M1535
TX
2084P0805X
Geriatric Psychiatry Physician
Primary
M1535
TX
Other
Enumeration date
07/26/2005
Last updated
06/12/2016
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