Provider Demographics
NPI:1730285834
Name:COLON & RECTAL ASSOCIATES OF NORTH TEXAS, P.A.
Entity Type:Organization
Organization Name:COLON & RECTAL ASSOCIATES OF NORTH TEXAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-382-7321
Mailing Address - Street 1:3321 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6817
Mailing Address - Country:US
Mailing Address - Phone:940-382-7321
Mailing Address - Fax:940-382-5453
Practice Address - Street 1:3321 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6817
Practice Address - Country:US
Practice Address - Phone:940-382-7321
Practice Address - Fax:940-382-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3076174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0074NZOtherBC & BS
TX185514001Medicaid
TXDN3066OtherR.R. MEDICARE
TX185514001Medicaid