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General NPI Number Information
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NPI Number | 1619268133
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS VASCULAR SPECIALISTS PA
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 2900 N I-35 STE 105
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City | DENTON
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State | TX
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Zip | 76201-5142
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Country | US
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Telephone | 940-591-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 N I-35 STE 105
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City | DENTON
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State | TX
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Zip | 76201-5142
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAUL ORTEGA
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Credential | M.D.
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Telephone | 940-591-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | N7567
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License Number State | TX
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