Provider Demographics
NPI:1629386214
Name:NORTH TEXAS EXPRESS CARE PROVIDERS PA
Entity type:Organization
Organization Name:NORTH TEXAS EXPRESS CARE PROVIDERS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:F
Authorized Official - Last Name:BRONOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-902-0000
Mailing Address - Street 1:9901 ROYAL LN
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-1830
Mailing Address - Country:US
Mailing Address - Phone:214-902-0000
Mailing Address - Fax:
Practice Address - Street 1:9901 ROYAL LN
Practice Address - Street 2:SUITE 106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-1830
Practice Address - Country:US
Practice Address - Phone:214-902-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care