Organization
NORTH TEXAS ID PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DHIRAJ KOTWAL MD (PRESIDENT)
(972) 853-7170
Entity
Organization
Contact information
Practice address
4517 SOUTHGATE DR, PLANO, TX 75024-2138
(972) 853-7170
Mailing address
4517 SOUTHGATE DR, PLANO, TX 75024-2138
(972) 853-7170
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
M 8773
TX
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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