Provider Demographics
NPI:1164534111
Name:MACARTHUR FAMILY PRACTICE
Entity Type:Organization
Organization Name:MACARTHUR FAMILY PRACTICE
Other - Org Name:MACARTHUR FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-259-8030
Mailing Address - Street 1:3501 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3636
Mailing Address - Country:US
Mailing Address - Phone:972-259-8030
Mailing Address - Fax:972-253-0706
Practice Address - Street 1:3501 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3636
Practice Address - Country:US
Practice Address - Phone:972-259-8030
Practice Address - Fax:972-253-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty