MEDICARE: MARVIN F FOJTASEK MD

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	207RI0200X	Infectious Disease Physician	F9429	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F9429	OTHER	TX	STATE MEDICAL LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669475737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARVIN F FOJTASEK MD

Provider Business Mailing Address
First Line	:	15301 SPECTRUM DR STE 330
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-6462
Country	:	US
Telephone Number	:	972-661-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	15301 SPECTRUM DR STE 330
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-6462
Country	:	US
Telephone Number	:	972-661-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/26/2024

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Directions to “ MARVIN F FOJTASEK MD” Practice Location

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