Provider Demographics
NPI:1023377496
Name:METHODIST OB GYN PLLC
Entity Type:Organization
Organization Name:METHODIST OB GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARZAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-941-0100
Mailing Address - Street 1:221 W COLORADO BLVD STE 728
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2357
Mailing Address - Country:US
Mailing Address - Phone:214-941-0100
Mailing Address - Fax:214-941-7024
Practice Address - Street 1:221 W COLORADO BLVD STE 728
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2357
Practice Address - Country:US
Practice Address - Phone:214-941-0100
Practice Address - Fax:214-941-7024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXJ9954207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307930301Medicaid
TXTXB160406Medicare PIN