Provider Demographics
NPI:1760560155
Name:INSITE INFUSION OF GARLAND PA
Entity Type:Organization
Organization Name:INSITE INFUSION OF GARLAND PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-494-1155
Mailing Address - Street 1:PO BOX 227435
Mailing Address - Street 2:DEPTARTMENT 129
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-7435
Mailing Address - Country:US
Mailing Address - Phone:972-494-1155
Mailing Address - Fax:972-494-6572
Practice Address - Street 1:2241 PEGGY LN STE F
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5732
Practice Address - Country:US
Practice Address - Phone:972-494-1155
Practice Address - Fax:972-494-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty