Provider Demographics
NPI:1326398173
Name:NORTH TEXAS PHYSICIANS ALLIANCE, PLLC
Entity Type:Organization
Organization Name:NORTH TEXAS PHYSICIANS ALLIANCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRATES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-250-5642
Mailing Address - Street 1:PO BOX 1383
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77251-1383
Mailing Address - Country:US
Mailing Address - Phone:281-820-1900
Mailing Address - Fax:281-453-1945
Practice Address - Street 1:5228 W PLANO PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5005
Practice Address - Country:US
Practice Address - Phone:972-250-5700
Practice Address - Fax:972-250-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK4399OtherSTATE BOARD MEDICAL PERMIT