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General NPI Number Information
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NPI Number | 1174802334
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Entity Type | Individual
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Provider Name | GORAN TESIC M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 7700 LAKEVIEW PKWY STE C
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City | ROWLETT
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State | TX
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Zip | 75088-4362
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Country | US
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Telephone | 972-487-1818
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Fax | 972-487-7928
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Provider Business Mailing Address
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Address Line | 7700 LAKEVIEW PKWY STE C
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City | ROWLETT
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State | TX
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Zip | 75088-4362
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Country | US
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Telephone | 972-487-1818
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Fax | 972-487-7928
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 125715
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | R8499
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License Number State | TX
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