Provider Demographics
NPI:1659301380
Name:NORTH TEXAS ENDOCRINE CENTER, P.A.
Entity Type:Organization
Organization Name:NORTH TEXAS ENDOCRINE CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEFFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-369-5992
Mailing Address - Street 1:9301 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 570
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0806
Mailing Address - Country:US
Mailing Address - Phone:214-369-5992
Mailing Address - Fax:214-369-2414
Practice Address - Street 1:9301 N CENTRAL EXPY
Practice Address - Street 2:SUITE 570
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0806
Practice Address - Country:US
Practice Address - Phone:214-369-5992
Practice Address - Fax:214-369-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00128ZMedicare ID - Type UnspecifiedMEDICARE GROUP PROV NO.