Provider Demographics
NPI:1891012654
Name:CTV SURGERY ASSOCIATES, P. A.
Entity Type:Organization
Organization Name:CTV SURGERY ASSOCIATES, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SCHORN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:972-253-4781
Mailing Address - Street 1:1110 COTTONWOOD LN
Mailing Address - Street 2:210
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6117
Mailing Address - Country:US
Mailing Address - Phone:972-259-4781
Mailing Address - Fax:972-251-1820
Practice Address - Street 1:1110 COTTONWOOD LN
Practice Address - Street 2:210
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6117
Practice Address - Country:US
Practice Address - Phone:972-259-4781
Practice Address - Fax:972-251-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1122208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty