Organization
CWIDA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN F FOJTASEK M.D. (PRESIDENT)
(972) 239-3849
Entity
Organization
Contact information
Practice address
15800 DOOLEY RD, SUITE 100, ADDISON, TX 75001-4284
(972) 239-3849
(866) 292-6489
Mailing address
15800 DOOLEY RD, SUITE 100, ADDISON, TX 75001-4284
(972) 239-3849
(866) 292-6489
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F9429
TX
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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