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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