Southlake Hospitalists LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M1046 Issued in TX

Legal business name

SOUTHLAKE HOSPITALISTS LLC

Practice address

1321 Bay Meadows Dr
Southlake, TX 76092-3938

Phone

(817) 521-4747

Fax

(214) 279-9273

NPI assigned

Apr 29, 2016

Organization subpart

No

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

Authorized official

Name

Elizabeth M Chandy, DONPI 1891741179

Title

Owner

Phone

(817) 521-4747

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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

• Elizabeth Chandy, D.O.

  • Internal Medicine Physician
  • Bedford, TX
  • NPI 1891741179
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1033564729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92941",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920941",
            "telephone_number": "817-521-4747",
            "fax_number": "214-279-9273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 BAY MEADOWS DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923938",
            "telephone_number": "817-521-4747",
            "fax_number": "214-279-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE HOSPITALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "CHANDY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-521-4747",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southlake GYN and Wellness Center, PLLC
• Southlake HB ABA Services LLC
• Southlake Health P.C.
• Southlake HK Group Health, LLC
• Southlake Hospice Care Inc
• Southlake Kidney Specialists, PLLC
• Southlake Medical Supplies, Inc.
• Southlake Mhya PLLC
• Southlake Natural Family Wellness, PLLC
• Southlake Neurology and

• Internal Medicine Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.