Provider Demographics
NPI:1124281282
Name:NORTH DALLAS PATIEINT CARE PA
Entity type:Organization
Organization Name:NORTH DALLAS PATIEINT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HITESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:YAGNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-403-1122
Mailing Address - Street 1:5930 W PARKER RD STE 900
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6427
Mailing Address - Country:US
Mailing Address - Phone:972-403-1122
Mailing Address - Fax:214-221-5600
Practice Address - Street 1:5930 W PARKER RD STE 900
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6427
Practice Address - Country:US
Practice Address - Phone:972-403-1122
Practice Address - Fax:214-221-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181678701Medicaid
TX181678701Medicaid