Basic Information
| Provider Information | |||||||||
| NPI: | 1619256716 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH TEXAS VILLAGE HEALTH PARTNERS, PA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | VILLAGE PEDIATRICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5425 W SPRING CREEK PKWY | ||||||||
| Address2: | STE 200 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750244237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728012144 | ||||||||
| FaxNumber: | 9725999696 | ||||||||
| Practice Location | |||||||||
| Address1: | 5425 W SPRING CREEK PKWY | ||||||||
| Address2: | STE 175 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750244237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728012144 | ||||||||
| FaxNumber: | 9725999696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2011 | ||||||||
| LastUpdateDate: | 08/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | CROW | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9725999600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.