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General NPI Number Information
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NPI Number | 1174994610
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Entity Type | Organization
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Legal Business Name | IN HIS GRIP PA
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 906 S BRYAN RD SUITE 205
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City | MISSION
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State | TX
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Zip | 78572-6657
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Country | US
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Telephone | 956-323-9030
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Fax |
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Provider Business Mailing Address
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Address Line | 902 S LOOP 499 APT 701
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City | HARLINGEN
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State | TX
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Zip | 78550-2515
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Country | US
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Telephone | 215-370-9505
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | PHILIP G MIDGLEY
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Credential | DO
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Telephone | 215-370-9505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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