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Organization
SURGERY ASSOCIATES OF NORTH TEXAS P A
Active
Organization
SURGERY ASSOCIATES OF NORTH TEXAS P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBY I SHYTLES (CREDENTIALING)
(940) 387-7588
Entity
Organization
Contact information
Practice address
3322 COLORADO BLVD, SUITE 101, DENTON, TX 76210-6864
(940) 387-7588
(940) 566-0881
Mailing address
3322 COLORADO BLVD, SUITE 101, DENTON, TX 76210-6864
(940) 387-7588
(940) 566-0881
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00MT04
BLUE CROSS OF TEXAS
TX
05
—
083992001
—
TX
Enumeration date
07/27/2006
Last updated
11/05/2009
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