# NORTH CENTRAL TEXAS INFECTIOUS DISEASE GROUP PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437426723
- **Authorized official:** EDWARD TOMOYE DO (D.O./PRESIDENT)
- **Authorized official phone:** (817) 921-1886

## Contact information

- **Practice address:** 650 SAINT LOUIS AVE, FORT WORTH, TX 76104-3346
- **Practice address phone:** (817) 921-1886
- **Mailing address:** 1169 N BURLESON BLVD, SUITE 107-235, BURLESON, TX 76028-7011
- **Mailing address phone:** (817) 921-1886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2011
- **Last updated:** 10/02/2013