Pro Physicians Clinic PA

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

PRO PHYSICIANS CLINIC PA

Practice address

920 Santa Fe Dr
Weatherford, TX 76086-5864

Phone

(817) 886-8730

NPI assigned

Feb 5, 2009

Organization subpart

Yes

Parent organization

PRO PHYSICIANS CLINIC PAAs reported in NPPES

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

Authorized official

Name

Jon D Tryggestad

Title

Ceo

Phone

(817) 886-8730

Specialties & licenses 1

Addresses

Part of

Pro Physicians Clinic PA

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1033358692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E JOHN CARPENTER FWY",
            "address_2": "SUITE 130",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623990",
            "telephone_number": "817-886-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 SANTA FE DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865864",
            "telephone_number": "817-886-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO PHYSICIANS CLINIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRO PHYSICIANS CLINIC PA",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "TRYGGESTAD",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-886-8730"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ximena Denisse Portillo
• Elizabeth High Poston
• Priscilla Powell Lyon, D.O.
• Nancy D. Powell, CRNA
• Powermill Performance, LLC
• Jamie Denae Procter
• Fayleen Marie Prosenick, MA, LPC-ASSOCIATE
• Prosperity Health
• Michael Steven Puhl, FNP
• Rhianna Dale Pultz

• Radiation Oncology Physician in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Radiation Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.