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General NPI Number Information
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NPI Number | 1679940902
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS CIN, INC.
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 15770 NORTH DALLAS PARKWAY SUITE 900
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City | DALLAS
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State | TX
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Zip | 75248
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Country | US
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Telephone | 469-573-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 COIT ROAD SUITE 103
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City | PLANO
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State | TX
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Zip | 75075
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Country | US
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Telephone | 469-573-1090
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Fax | 469-250-1699
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN MOORE
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Credential | MD
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Telephone | 214-693-8228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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