Provider Demographics
NPI:1932296191
Name:NORTH TEXAS INFECTIOUS DISAEASES CONSULTANTS, PA
Entity Type:Organization
Organization Name:NORTH TEXAS INFECTIOUS DISAEASES CONSULTANTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEZGEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:214-823-2533
Mailing Address - Street 1:3409 WORTH ST STE 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2061
Mailing Address - Country:US
Mailing Address - Phone:214-823-2533
Mailing Address - Fax:214-370-3316
Practice Address - Street 1:3409 WORTH ST STE 710
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2061
Practice Address - Country:US
Practice Address - Phone:214-823-2533
Practice Address - Fax:214-823-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH76EMedicare PIN