Provider Demographics
NPI:1497762546
Name:ARNOLD DO, INGRID E (DO)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:E
Last Name:ARNOLD DO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 GUS THOMASSON RD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-7100
Mailing Address - Country:US
Mailing Address - Phone:972-270-5417
Mailing Address - Fax:972-270-0371
Practice Address - Street 1:2375 GUS THOMASSON RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-7100
Practice Address - Country:US
Practice Address - Phone:972-270-5417
Practice Address - Fax:972-270-0371
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035221301Medicaid
TX035221301Medicaid
TXC12954Medicare UPIN