Provider Demographics
NPI:1952761173
Name:CONCORD NORTH TEXAS, PLLC
Entity type:Organization
Organization Name:CONCORD NORTH TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-264-0330
Mailing Address - Street 1:PO BOX 11077
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-1077
Mailing Address - Country:US
Mailing Address - Phone:863-274-7800
Mailing Address - Fax:338-869-8967
Practice Address - Street 1:504 LIPSCOMB ST
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-4028
Practice Address - Country:US
Practice Address - Phone:888-264-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X
TXP4224207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty