Provider Demographics
NPI:1720286735
Name:NORTH DALLAS FAMILY CARE PA
Entity Type:Organization
Organization Name:NORTH DALLAS FAMILY CARE PA
Other - Org Name:ADRIAN MEYER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-231-6341
Mailing Address - Street 1:200 S COTTONWOOD DR STE A
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5740
Mailing Address - Country:US
Mailing Address - Phone:972-231-6341
Mailing Address - Fax:
Practice Address - Street 1:200 S COTTONWOOD DR STE A
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5740
Practice Address - Country:US
Practice Address - Phone:972-231-6341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1819171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherITIN
TX=========OtherITIN
TXC19339Medicare UPIN