Organization
NORTH DALLAS ENT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DENISE BANNO (OFFICE MANAGER)
(972) 566-4071
Entity
Organization
Contact information
Practice address
12720 HILLCREST RD STE 900, DALLAS, TX 75230-2047
(972) 566-8300
(972) 566-8004
Mailing address
9330 LBJ FWY STE 800, DALLAS, TX 75243-4310
(972) 566-8300
(972) 566-8004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063PM
BLUE CROSS OF TEXAS
TX
01
—
0077HR
TRONE BCTX
TX
05
—
110688201
—
TX
Enumeration date
03/22/2007
Last updated
07/30/2025
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