Provider Demographics
NPI:1780179267
Name:AVEO MEDICAL GROUP - NORTH TEXAS PLLC
Entity Type:Organization
Organization Name:AVEO MEDICAL GROUP - NORTH TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTOREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-255-7011
Mailing Address - Street 1:9041 MEADOWKNOLL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7518
Mailing Address - Country:US
Mailing Address - Phone:214-695-1183
Mailing Address - Fax:
Practice Address - Street 1:8600 SKYLINE DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243
Practice Address - Country:US
Practice Address - Phone:214-695-1183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty