Provider Demographics
NPI:1326317702
Name:MEDICAL GROUP OF NORTH TEXAS, PA
Entity Type:Organization
Organization Name:MEDICAL GROUP OF NORTH TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-268-2315
Mailing Address - Street 1:PO BOX 12171
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225
Mailing Address - Country:US
Mailing Address - Phone:214-324-6770
Mailing Address - Fax:
Practice Address - Street 1:9330 POPPY DRIVE
Practice Address - Street 2:SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3336
Practice Address - Country:US
Practice Address - Phone:214-324-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty