MEDICARE: NORTH TEXAS PHYSICIAN ASSOCIATES, 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
1	174400000X	Specialist		TX

General Provider Information

NPI Number	:	1437387362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TEXAS PHYSICIAN ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	333 N SHILOH RD STE 102
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6613
Country	:	US
Telephone Number	:	972-487-8880
Fax Number	:	866-288-3708

Provider Business Practice Location Address
First Line	:	333 N SHILOH RD STE 102
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6613
Country	:	US
Telephone Number	:	972-487-8880
Fax Number	:	866-288-3708

Authorized Official
Title or Position	:	BUS MANAGER
Name	:	MR. JEFF BICKART
Credential	:
Telephone Number	:	281-938-4434

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	06/30/2009

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