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NPI Code Detail

MEDICARE: NORTH TEXAS PREMIER PHYSICIANS GROUP PLLC

MEDICARE: NORTH TEXAS PREMIER PHYSICIANS GROUP PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1295376291
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH TEXAS PREMIER PHYSICIANS GROUP PLLC
Provider Business Mailing Address
First Line : 13154 COIT RD STE 102D
Second Line :
City : DALLAS
State : TX
Zip : 75240-5795
Country : US
Telephone Number : 469-726-2205
Fax Number :
Provider Business Practice Location Address
First Line : 4512 RALPH LN
Second Line :
City : DALLAS
State : TX
Zip : 75227-1845
Country : US
Telephone Number : 469-726-2205
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JULIO OLIVIERI
Credential : MD
Telephone Number : 972-809-4753
Provider Enumeration Date : 10/01/2019
Last Update Date : 10/01/2019

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Directions to “NORTH TEXAS PREMIER PHYSICIANS GROUP PLLC ” Practice Location

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