Provider Demographics
NPI: | 1720067358 |
---|---|
Name: | CLINICS OF NORTH TEXAS LLP |
Entity Type: | Organization |
Organization Name: | CLINICS OF NORTH TEXAS LLP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | OZIER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | M D |
Authorized Official - Phone: | 940-397-5413 |
Mailing Address - Street 1: | 501 MIDWESTERN PKWY E |
Mailing Address - Street 2: | |
Mailing Address - City: | WICHITA FALLS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76302-2302 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 940-766-3551 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 501 MIDWESTERN PKWY E |
Practice Address - Street 2: | |
Practice Address - City: | WICHITA FALLS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 76302-2302 |
Practice Address - Country: | US |
Practice Address - Phone: | 940-766-3551 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-01-12 |
Last Update Date: | 2016-01-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
No | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | Group - Multi-Specialty |
No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Multi-Specialty |
No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 1212227-03 | Medicaid | |
TX | 00F327 | Medicare PIN | |
TX | 1212227-03 | Medicaid |