Provider Demographics
NPI:1497951321
Name:TEXAS VESTIBULAR DIAGNOSTICS
Entity Type:Organization
Organization Name:TEXAS VESTIBULAR DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ERWIN A. CRUZ M.D.
Authorized Official - Prefix:
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-503-2780
Mailing Address - Street 1:12800 PRESTON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1366
Mailing Address - Country:US
Mailing Address - Phone:972-503-2780
Mailing Address - Fax:
Practice Address - Street 1:12800 PRESTON RD STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1366
Practice Address - Country:US
Practice Address - Phone:972-503-2780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty