Organization
INTELLIMEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE TYROCH MD (PHYSICIAN/OWNER)
(915) 532-5858
Entity
Organization
Contact information
Practice address
154 NORTH FESTIVAL DRIVE, VILLA F, EL PASO, TX 79912-6184
(915) 532-5858
(915) 532-5859
Mailing address
5823 N MESA ST # 537, EL PASO, TX 79912-4607
(915) 261-4377
(915) 532-5859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K1945
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K1945
TX MED LIC
TX
Enumeration date
03/17/2014
Last updated
04/18/2024
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