Provider Demographics
NPI:1689288342
Name:NORTEX MEDICAL GROUP
Entity Type:Organization
Organization Name:NORTEX MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WOJNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-330-4264
Mailing Address - Street 1:5999 CUSTER RD # 110-523
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9302
Mailing Address - Country:US
Mailing Address - Phone:972-330-4264
Mailing Address - Fax:972-850-7352
Practice Address - Street 1:981 STATE HIGHWAY 121 STE 4150
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:972-330-4264
Practice Address - Fax:972-850-7352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty