Provider Demographics
NPI:1144268186
Name:MD ON CALL PA
Entity type:Organization
Organization Name:MD ON CALL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-766-7282
Mailing Address - Street 1:801 E CAMPBELL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6797
Mailing Address - Country:US
Mailing Address - Phone:214-766-7282
Mailing Address - Fax:214-377-3701
Practice Address - Street 1:5601 WARREN PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4069
Practice Address - Country:US
Practice Address - Phone:214-766-7282
Practice Address - Fax:214-377-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083185101Medicaid
TX161088301Medicaid
TX161088301Medicaid
TX00942TMedicare PIN