Basic Information
| Provider Information | |||||||||
| NPI: | 1972988699 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH TEXAS OB-GYN ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 328 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750573866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724367557 | ||||||||
| FaxNumber: | 9722218246 | ||||||||
| Practice Location | |||||||||
| Address1: | 328 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750573866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724367557 | ||||||||
| FaxNumber: | 9722218246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2015 | ||||||||
| LastUpdateDate: | 07/23/2015 | ||||||||
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| AuthorizedOfficialLastName: | TOVAR | ||||||||
| AuthorizedOfficialFirstName: | RUDOLPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9724367557 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Q2707 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.