Provider Demographics
NPI:1346879350
Name:ROCKWALL ELITE HEALTHCARE PLLC
Entity Type:Organization
Organization Name:ROCKWALL ELITE HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MIGLIACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-961-0673
Mailing Address - Street 1:105 N GOLIAD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-2539
Mailing Address - Country:US
Mailing Address - Phone:972-961-0673
Mailing Address - Fax:972-961-0673
Practice Address - Street 1:105 N GOLIAD ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2539
Practice Address - Country:US
Practice Address - Phone:972-961-0673
Practice Address - Fax:972-551-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty