Provider Demographics
NPI:1023529120
Name:NORTEX INTEGRATED MEDICINE PLLC - FUSION SERIES
Entity type:Organization
Organization Name:NORTEX INTEGRATED MEDICINE PLLC - FUSION SERIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DEPARTMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:AMBER
Authorized Official - Last Name:HOWINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-775-5857
Mailing Address - Street 1:9191 KYSER WAY STE 605
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1954
Mailing Address - Country:US
Mailing Address - Phone:469-362-6461
Mailing Address - Fax:469-362-6475
Practice Address - Street 1:9191 KYSER WAY STE 605
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1954
Practice Address - Country:US
Practice Address - Phone:469-362-6461
Practice Address - Fax:469-362-6475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7044208100000X, 207Q00000X
TXZ70442081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty