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Organization
NORTH DALLAS EAR, NOSE, AND THROAT PA
Active
Organization
NORTH DALLAS EAR, NOSE, AND THROAT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORRIS GOTTLIEB (PRESIDENT)
(972) 480-8877
Entity
Organization
Contact information
Practice address
2821 E PRESIDENT GEORGE BUSH HWY, SUITE 509, RICHARDSON, TX 75082-4266
(972) 480-8877
Mailing address
PO BOX 25887, OKLAHOMA CITY, OK 73125-0887
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076LT
BCBS
TX
05
—
1678864-01
—
TX
01
—
DC1384
MEDICARE RAILROAD
TX
Enumeration date
07/22/2006
Last updated
05/04/2011
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