MEDICARE: NORTH TEXAS MEDICAL GROUP

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1356311732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TEXAS MEDICAL GROUP

Provider Business Mailing Address
First Line	:	6020 W PARKER RD
Second Line	:	#420
City	:	PLANO
State	:	TX
Zip	:	75093
Country	:	US
Telephone Number	:	972-244-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	6020 W PARKER RD
Second Line	:	SUITE 420
City	:	PLANO
State	:	TX
Zip	:	75093-8171
Country	:	US
Telephone Number	:	972-244-1300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SCOTT W YATES
Credential	:	MD
Telephone Number	:	972-244-1300

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	07/12/2007

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Directions to “NORTH TEXAS MEDICAL GROUP ” Practice Location

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