Provider Demographics
NPI:1164626024
Name:PEDRO NOSNIK, M.D., P.A.
Entity Type:Organization
Organization Name:PEDRO NOSNIK, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-985-9048
Mailing Address - Street 1:4100 W 15TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5801
Mailing Address - Country:US
Mailing Address - Phone:972-985-9048
Mailing Address - Fax:972-867-2051
Practice Address - Street 1:4100 W 15TH ST STE 206
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5801
Practice Address - Country:US
Practice Address - Phone:972-985-9048
Practice Address - Fax:972-867-2051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF35692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00337XMedicare PIN