MEDICARE: NORTEX ANESTHESIA, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1053977694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTEX ANESTHESIA, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 251529
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-1500
Country	:	US
Telephone Number	:	469-215-3494
Fax Number	:	888-770-6360

Provider Business Practice Location Address
First Line	:	2200 PHYSICIANS BLVD STE A
Second Line	:
City	:	ENNIS
State	:	TX
Zip	:	75119-6248
Country	:	US
Telephone Number	:	469-215-3494
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. GARY D MARTIN JR.
Credential	:	MD
Telephone Number	:	469-215-3494

Provider Enumeration Date	:	05/18/2019
Last Update Date	:	11/17/2020

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