Organization Active NPI

Intire Health Physician Group

  • Interventional Pain Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1467037465
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
INTIRE HEALTH PHYSICIAN GROUP
Practice address
517 N Carrier Pkwy
Grand Prairie, TX 75050-5484
Phone
(469) 251-1734
NPI assigned
Mar 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miguel Del Bosque
Title
Owner
Phone
(469) 251-1734

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

517 N Carrier Pkwy
Grand Prairie, TX 75050-5484

Mailing address

517 N Carrier Pkwy
Grand Prairie, TX 75050-5484
Phone (469) 251-1734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210527001575 TX Part B Supplier - Clinic/Group Practice 4385043173 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Prairie, TX

National Provider Directory

National Provider Directory

Locations

517 N Carrier Pkwy
Ste A
Grand Prairie, TX 75050
Phone (972) 264-0533

815 Greenview Dr
Grand Prairie, TX 75050
Phone (469) 251-1734

517 N Carrier Pkwy
Grand Prairie, TX 75050
Phone (214) 460-0644

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1467037465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505484",
            "telephone_number": "469-251-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 N CARRIER PKWY",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505484",
            "telephone_number": "469-251-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTIRE HEALTH PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "DEL BOSQUE",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-251-1734"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.