Individual provider Active NPI

Brandon L Bloch, M.D.

  • Gastroenterology Physician
  • Plano, TX
National Provider Identifier
1053370940
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
F1394 Issued in TX
Practice address
3105 W 15TH St
Suite B
Plano, TX 75075-7700
Phone
(972) 769-1600
Fax
(972) 612-3473
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X F1394 TX Primary

Addresses

Primary practice location

3105 W 15TH St
Suite B
Plano, TX 75075-7700

Mailing address

7610 Stemmons Fwy
Suite 500
Dallas, TX 75247-4231
Phone (214) 689-5960

Other identifiers 2

IdentifierTypeStateIssuer
84Y120OtherTXBCBSTX
113978403MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
F1394TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Associates of Texas, P.a. Gastroenterology Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1053370940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 STEMMONS FWY",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474231",
            "telephone_number": "214-689-5960",
            "fax_number": "214-630-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST",
            "address_2": "SUITE B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757700",
            "telephone_number": "972-769-1600",
            "fax_number": "972-612-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCH",
        "first_name": "BRANDON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "F1394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "84Y120",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113978403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; 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.