Provider Demographics
NPI:1639368889
Name:DR BOSE INDUSTRIAL & FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:DR BOSE INDUSTRIAL & FAMILY MEDICINE PLLC
Other - Org Name:ASHLEY FAMILY & INDUSTRIAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAROJINI
Authorized Official - Middle Name:G
Authorized Official - Last Name:BOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-259-0400
Mailing Address - Street 1:801 E NOLANA AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6113
Mailing Address - Country:US
Mailing Address - Phone:956-668-7333
Mailing Address - Fax:956-668-7999
Practice Address - Street 1:801 E NOLANA AVE STE 6
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6113
Practice Address - Country:US
Practice Address - Phone:956-668-7333
Practice Address - Fax:956-668-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197496601Medicaid