Provider Demographics
NPI:1467808618
Name:DOCTX3 PLLC
Entity Type:Organization
Organization Name:DOCTX3 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SISNER
Authorized Official - Prefix:
Authorized Official - First Name:MERRITT
Authorized Official - Middle Name:
Authorized Official - Last Name:PEMBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-983-0303
Mailing Address - Street 1:2805 DALLAS PKWY
Mailing Address - Street 2:SUITE 640
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8719
Mailing Address - Country:US
Mailing Address - Phone:214-983-0303
Mailing Address - Fax:214-983-0301
Practice Address - Street 1:3014 N. O'CONNOR RD.
Practice Address - Street 2:SUITE 110
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062
Practice Address - Country:US
Practice Address - Phone:214-277-3404
Practice Address - Fax:214-983-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX541053Medicare PIN
TX541049Medicare PIN
TX541041Medicare PIN
TX541040Medicare PIN