Organization Active NPI

Exemplar Practitioners of Texas LLC

  • Nurse Practitioner
  • Missouri City, TX
National Provider Identifier
1003468042
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
EXEMPLAR PRACTITIONERS OF TEXAS LLC
Practice address
2106 Ironwood Pass Dr
Missouri City, TX 77459-3781
Phone
(832) 600-5144
NPI assigned
Jul 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brent Eaton, NP, LSA, CRNFANPI 1699894378
Title
Managing Member
Phone
(832) 600-5144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

2106 Ironwood Pass Dr
Missouri City, TX 77459-3781

Mailing address

2106 Ironwood Pass Dr
Missouri City, TX 77459-3781
Phone (832) 600-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190812001851 TX Part B Supplier - Clinic/Group Practice 2365779592 Receives reassigned benefits from 1 practitioner
Practice locations: Sugar Land, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1003468042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD PASS DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593781",
            "telephone_number": "832-600-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD PASS DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593781",
            "telephone_number": "832-600-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXEMPLAR PRACTITIONERS OF TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "832-600-5144",
        "authorized_official_credential": "NP, LSA, CRNFA"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.