Provider Demographics
NPI:1619913290
Name:NORTH TEXAS ORTHOPEDICS
Entity Type:Organization
Organization Name:NORTH TEXAS ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:CREECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-564-4900
Mailing Address - Street 1:PO BOX 793897
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379
Mailing Address - Country:US
Mailing Address - Phone:972-564-4900
Mailing Address - Fax:
Practice Address - Street 1:711 W BROAD
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126
Practice Address - Country:US
Practice Address - Phone:972-564-4900
Practice Address - Fax:972-564-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000966075009OtherUNITED HEALTHCARE GREENVILLE
TX4339593OtherAETNA
TX200035671OtherMEDICARE RAILROAD
TX000966075019OtherUNITED HEALTHCARE FORNEY
TX0048DJOtherBC/BS
TX0018907003OtherCIGNA
TX128293104Medicaid
TXCF8743OtherRAILROAD MEDICARE GROUP
TX109409602OtherMEDICAID TPI GROUP
TXCF8743OtherRAILROAD MEDICARE GROUP