MEDICARE: UPWARD HEALTH OF TEXAS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1952993065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPWARD HEALTH OF TEXAS PA

Provider Business Mailing Address
First Line	:	80 ARKAY DR STE 230
Second Line	:
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-3705
Country	:	US
Telephone Number	:	888-985-5455
Fax Number	:

Provider Business Practice Location Address
First Line	:	6112 N MESA ST # 6092
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4516
Country	:	US
Telephone Number	:	888-985-5455
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENNIS MIHALE
Credential	:	MD
Telephone Number	:	889-855-4558

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	10/19/2021

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Directions to “UPWARD HEALTH OF TEXAS PA ” Practice Location

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