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General NPI Number Information
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NPI Number | 1992433262
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Entity Type | Organization
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Legal Business Name | INTRICATE HEALTH
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 525 SHILOH RD STE 2100
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City | PLANO
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State | TX
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Zip | 75074-7264
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Country | US
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Telephone | 469-599-2212
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Fax | 469-245-0039
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Provider Business Mailing Address
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Address Line | PO BOX 942189
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City | PLANO
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State | TX
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Zip | 75094-2189
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARMAINE C GIBSON
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Credential | MD
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Telephone | 469-640-6423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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