Basic Information
| Provider Information | |||||||||
| NPI: | 1013455443 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTEX INTEGRATED MEDICINE PLLC - DALLAS SERIES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7000 PRESTON RD STE 1500 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750242512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728408 | ||||||||
| FaxNumber: | 9728507352 | ||||||||
| Practice Location | |||||||||
| Address1: | 7000 PRESTON RD STE 1500 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750242512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728408 | ||||||||
| FaxNumber: | 9728507352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2017 | ||||||||
| LastUpdateDate: | 02/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | GHALAMBOR | ||||||||
| AuthorizedOfficialFirstName: | OMID | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9728728408 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Q7044 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 208VP0014X | Q7044 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 2081P2900X | Q7044 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.