Provider Demographics
NPI:1255475539
Name:ARTHRITIS CENTERS OF TEXAS PA
Entity Type:Organization
Organization Name:ARTHRITIS CENTERS OF TEXAS PA
Other - Org Name:ARTHRITIS CENTERS OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-823-6506
Mailing Address - Street 1:712 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1619
Mailing Address - Country:US
Mailing Address - Phone:214-823-6503
Mailing Address - Fax:214-826-0605
Practice Address - Street 1:712 N WASHINGTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1619
Practice Address - Country:US
Practice Address - Phone:214-823-6503
Practice Address - Fax:214-826-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCP7207Medicare PIN
TX00JH18Medicare PIN