Provider Demographics
NPI:1891353942
Name:ENDOCRINOLOGY AND DIABETES INSTITUTE OF NORTH TEXAS
Entity Type:Organization
Organization Name:ENDOCRINOLOGY AND DIABETES INSTITUTE OF NORTH TEXAS
Other - Org Name:ENDO DIABETES INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MANLAPAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-552-6627
Mailing Address - Street 1:14850 MONTFORT DRIVE
Mailing Address - Street 2:SUITE 181, LB 11
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254
Mailing Address - Country:US
Mailing Address - Phone:214-550-1469
Mailing Address - Fax:214-446-6010
Practice Address - Street 1:920 E HIGHWAY 67 STE 100
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-2713
Practice Address - Country:US
Practice Address - Phone:214-471-5407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty