CWIDA, INC


Address: 15800 Dooley Rd Ste 170, Addison, TX 75001-5712
Phone: 9726612273

CWIDA, INC (NPI# 1689089401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689089401
Entity Type Organization
Organization Name CWIDA, INC
Practice Address 15800 Dooley Rd Ste 170
Addison
TX 75001-5712
Mailing Address 4400 W University Blvd
Apt: 10306
Dallas
TX 75209-3876
Practice Telephone 9726612273
Practice Fax Number 8662926489
Mailing Telephone 8177295793
Mailing Fax Number 8662926489
Enumeration Date 2014-07-01
Last Update Date 2014-07-01
Authorized Official Name DR. MARVIN FOJTAEK (OWNER)
Authorized Official Telephone 9726612273
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WG0600X Registered Nurse
Specialization: Gerontology
767459 TX Nursing Service Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
AP125351 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 15800 DOOLEY RD STE 170
City ADDISON
State TX
Zip Code 75001-5712

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City ADDISON
Zip Code 75001

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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