Provider Demographics
NPI:1376193433
Name:NTKC - DFW, PLLC
Entity Type:Organization
Organization Name:NTKC - DFW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-488-6812
Mailing Address - Street 1:3801 WILLIAM D TATE AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8755
Mailing Address - Country:US
Mailing Address - Phone:817-488-6812
Mailing Address - Fax:817-251-1303
Practice Address - Street 1:10700 VICTORIA ASH DR.
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76244
Practice Address - Country:US
Practice Address - Phone:817-283-5166
Practice Address - Fax:817-283-5176
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NTKC - DFW, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty