# BOSTON MEDICAL GROUP - TEXAS, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boston Medical Group Texas PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750708061
- **Authorized official:** JOAN SIMPSON (DIRECTOR)
- **Authorized official phone:** (615) 562-4048

## Contact information

- **Practice address:** 12801 N CENTRAL EXPY STE 1107, DALLAS, TX 75243-1893
- **Practice address phone:** (469) 374-0439
- **Practice address fax:** (469) 374-0629
- **Mailing address:** 12801 N CENTRAL EXPY STE 1107, DALLAS, TX 75243-1893
- **Mailing address phone:** (469) 374-0439
- **Mailing address fax:** (469) 374-0629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/25/2014
- **Last updated:** 01/31/2020