Healthcare Provider Details

I. General information

NPI: 1740264977
Provider Name (Legal Business Name): NORTH TEXAS PERINATAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W CAMPBELL RD #207
RICHARDSON TX
75080-3465
US

IV. Provider business mailing address

1700 COIT RD #290
PLANO TX
75075-6138
US

V. Phone/Fax

Practice location:
  • Phone: 972-498-8320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GILBERT DROZDOW
Title or Position: SENIOR VICE PRESIDENT
Credential: M.D
Phone: 954-838-2371