Organization · Type 2 NPI

Innovista Provider Group Texas PA

Family Medicine Physician · Irving, TX

NPI number 1144875626 Active

Practice location

6500 N Macarthur Blvd
Irving, TX 75039-2460

Call (305) 470-2929 Map

Mailing address

PO Box 8150
Westchester, IL 60154-8150

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2 other providers at this address

Other family medicine physician providers in Irving

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NPI record

NPI: 1144875626
Entity type: Organization (Type 2)
Issued: Aug 1, 2019
Last updated: Jun 2, 2025
Status: Active
Subpart: Yes of Innovista Provider Group Texas PA

Other names

<unavail>
Innovista Las Colinas · doing business as
Innovista Medical Center of TX PA · former legal business name

Authorized official

Mia Willhite
COO
(269) 720-7042

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1144875626

Innovista Provider Group Texas PA's National Provider Identifier is 1144875626, issued on Aug 1, 2019. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Irving, TX. The record was last updated on Jun 2, 2025.