Provider Demographics
NPI:1063691475
Name:NORTH TEXAS RHEUMATOLOGY ASSOCIATES, P.A.
Entity type:Organization
Organization Name:NORTH TEXAS RHEUMATOLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DUBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-239-2301
Mailing Address - Street 1:16106 SHADYBANK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2961
Mailing Address - Country:US
Mailing Address - Phone:972-239-2301
Mailing Address - Fax:
Practice Address - Street 1:16106 SHADYBANK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-2961
Practice Address - Country:US
Practice Address - Phone:972-239-2301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0096AEMedicare PIN