NPIMap

Organization Active NPI

Stonebridge Health PLLC

Doing business as Stonebridge Clinics

  • Multi-Specialty Clinic/Center
  • The Colony, TX
National Provider Identifier
1023684362
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
STONEBRIDGE HEALTH PLLC
Doing business as
Stonebridge Clinics
Practice address
7204 Main St Ste 200
The Colony, TX 75056-3498
Phone
(469) 535-3800
Fax
(469) 533-0399
NPI assigned
May 27, 2021
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
STONEBRIDGE HEALTH PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Dr. Andrew Alexander Oteo, DCNPI 1770886632
Title
President
Phone
(214) 563-1414

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

7204 Main St Ste 200
The Colony, TX 75056-3498

Mailing address

7204 Main St Ste 200
The Colony, TX 75056-3498
Phone (469) 535-3800

Other names 1

  • STONEBRIDGE CLINICS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210610000284 TX Part B Supplier - Clinic/Group Practice 2668872805 Receives reassigned benefits from 5 practitioners
Practice locations: The Colony, TX
O20221021000549 TX DME Supplier - Physician - Family Practice 2668872805 Practice locations: The Colony, TX

National Provider Directory

National Provider Directory
Part of
Stonebridge Health PLLC

Locations

7204 Main St
Ste 200
The Colony, TX 75056
Phone (469) 535-3800

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1023684362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7204 MAIN ST STE 200",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750563498",
            "telephone_number": "469-535-3800",
            "fax_number": "469-533-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7204 MAIN ST STE 200",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750563498",
            "telephone_number": "469-535-3800",
            "fax_number": "469-533-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEBRIDGE HEALTH PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONEBRIDGE HEALTH PLLC",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "OTEO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-563-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STONEBRIDGE CLINICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STONEBRIDGE CLINICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in The Colony, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.