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1346534757
IRA KAEO BOSWELL
DALLAS, TX
NPI
1346534757
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: TX Q3645)
Enumeration Date
2011-06-02
Last Update Date
2022-01-26
Business Address
IRA KAEO BOSWELL D.O.
5706 E MOCKINGBIRD LN STE 115-33
DALLAS, TX 75206-5460
Phone number: 817-284-9850
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Mailing Address
IRA KAEO BOSWELL D.O.
PO BOX 678135
DALLAS, TX 75267-8135
Phone number: 469-818-0595
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