Healthcare Provider Details

I. General information

NPI: 1861273211
Provider Name (Legal Business Name): NORTH TEXAS CENTER FOR RHEUMATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12740 HILLCREST RD STE 265
DALLAS TX
75230-2086
US

IV. Provider business mailing address

12740 HILLCREST RD STE 265
DALLAS TX
75230-2086
US

V. Phone/Fax

Practice location:
  • Phone: 972-513-1410
  • Fax: 469-565-9885
Mailing address:
  • Phone: 972-513-1410
  • Fax: 469-565-9885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARITA FALLENA
Title or Position: PARTNER
Credential: MD
Phone: 972-513-1410