NPI 1003161274

Benson Igboeli

Practitioner PACE Provider Organization Grand Prairie, TX

Practice location

Address: 829 Springwood Dr, Grand Prairie, TX 75052-6092
Phone: (972) 262-5828
Fax: (972) 262-5828

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence 000000000000 (TX)

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Texas →

Registry record

NPI: 1003161274
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jul 2012
Record last updated: 13 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.