Provider Demographics
NPI:1356528806
Name:WOMEN'S MEDICAL ASSOCIATES OF NORTH TEXAS
Entity type:Organization
Organization Name:WOMEN'S MEDICAL ASSOCIATES OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:RAJALA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-747-4848
Mailing Address - Street 1:P.O. BOX 1510
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069
Mailing Address - Country:US
Mailing Address - Phone:972-747-4848
Mailing Address - Fax:972-747-4949
Practice Address - Street 1:1105 CENTRAL EXPY N
Practice Address - Street 2:SUITE 310
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6103
Practice Address - Country:US
Practice Address - Phone:972-747-4848
Practice Address - Fax:972-747-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5352207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T79ZOtherMEDICARE
1356528806OtherNIP