Organization
INTIRE HEALTH PHYSICIAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL DEL BOSQUE (OWNER)
(469) 251-1734
Entity
Organization
Contact information
Practice address
517 N CARRIER PKWY, GRAND PRAIRIE, TX 75050-5484
(469) 251-1734
Mailing address
517 N CARRIER PKWY, GRAND PRAIRIE, TX 75050-5484
(469) 251-1734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/11/2021
Last updated
03/11/2021
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