Provider Demographics
NPI:1386914083
Name:NORTH TEXAS PROVIDERS, L.L.C.
Entity type:Organization
Organization Name:NORTH TEXAS PROVIDERS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-221-7117
Mailing Address - Street 1:PO BOX 472308
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75047-2308
Mailing Address - Country:US
Mailing Address - Phone:214-221-7117
Mailing Address - Fax:972-271-2135
Practice Address - Street 1:1201 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7100
Practice Address - Country:US
Practice Address - Phone:214-221-7117
Practice Address - Fax:972-271-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty