Provider Demographics
NPI:1245619063
Name:IRA BOSWELL DO PLLC
Entity type:Organization
Organization Name:IRA BOSWELL DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-284-9850
Mailing Address - Street 1:5706 E MOCKINGBIRD LN STE 115-33
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5460
Mailing Address - Country:US
Mailing Address - Phone:817-284-9850
Mailing Address - Fax:817-284-9859
Practice Address - Street 1:2301 MARSH LN STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8497
Practice Address - Country:US
Practice Address - Phone:817-284-9850
Practice Address - Fax:817-284-9859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty