North Texas Id PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

M 8773 Issued in TX

Legal business name

NORTH TEXAS ID PA

Practice address

4517 Southgate Dr
Plano, TX 75024-2138

Phone

(972) 853-7170

NPI assigned

Jun 3, 2016

Last updated

Jun 3, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dhiraj Kotwal, MD

Title

President

Phone

(972) 853-7170

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1215386933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 SOUTHGATE DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242138",
            "telephone_number": "972-853-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 SOUTHGATE DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242138",
            "telephone_number": "972-853-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS ID PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "KOTWAL",
        "authorized_official_first_name": "DHIRAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-853-7170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TX",
            "license": "M 8773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Texas Family Therapy, PLLC
• North Texas Flu Shots LLC
• North Texas Gi Hospitalists, LLC
• North Texas Home Health Care, Inc.
• North Texas Hospital Physicians Group
• North Texas Infectious Diseases Consultants, PA
• North Texas Institute of Neurology and Headache, PA
• North Texas Institute of Neurology and Headache, PA
• North Texas Integrated Medical PLLC
• North Texas Kidney Disease Associates

• Medical Specialty Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.