Organization Active NPI

Cwida, Inc

  • Gerontology Nurse Practitioner
  • Addison, TX
National Provider Identifier
1689089401
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP125351 Issued in TX
Legal business name
CWIDA, INC
Practice address
15800 Dooley Rd Ste 170
Addison, TX 75001-5712
Phone
(972) 661-2273
Fax
(866) 292-6489
NPI assigned
Jul 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Dr. Marvin Fojtaek, MD
Title
Owner
Phone
(972) 661-2273

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WG0600X 767459 TX
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X AP125351 TX Primary

Addresses

Primary practice location

15800 Dooley Rd Ste 170
Addison, TX 75001-5712

Mailing address

4400 W University Blvd
Apt: 10306
Dallas, TX 75209-3876
Phone (817) 729-5793

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1689089401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W UNIVERSITY BLVD",
            "address_2": "APT: 10306",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752093876",
            "telephone_number": "817-729-5793",
            "fax_number": "866-292-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 DOOLEY RD STE 170",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750015712",
            "telephone_number": "972-661-2273",
            "fax_number": "866-292-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CWIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "FOJTAEK",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-661-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Gerontology",
            "state": "TX",
            "license": "767459",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP125351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.