Provider Demographics
NPI:1295376291
Name:NORTH TEXAS PREMIER PHYSICIANS GROUP PLLC
Entity Type:Organization
Organization Name:NORTH TEXAS PREMIER PHYSICIANS GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-809-4753
Mailing Address - Street 1:13154 COIT RD STE 102D
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5795
Mailing Address - Country:US
Mailing Address - Phone:469-726-2205
Mailing Address - Fax:
Practice Address - Street 1:4512 RALPH LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-1845
Practice Address - Country:US
Practice Address - Phone:469-726-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty