NPIMap

Organization Active NPI

South Texas Dental Associate, L.P.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1063630465
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16570 Issued in TX
Legal business name
SOUTH TEXAS DENTAL ASSOCIATE, L.P.
Practice address
4343 W Camp Wisdom Rd Ste 102
Dallas, TX 75237-2467
Phone
(972) 572-3552
Fax
(972) 572-3745
NPI assigned
Apr 23, 2007
Last updated
Jul 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Barry James Gomel, DDS
Title
Officer/Partner
Phone
(713) 663-7960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16570 TX Primary

Addresses

Primary practice location

4343 W Camp Wisdom Rd Ste 102
Dallas, TX 75237-2467

Mailing address

6300 West Loop S Ste 650
Bellaire, TX 77401-2997
Phone (713) 663-7960

National Provider Directory

National Provider Directory
Tax ID family
South Texas Dental Associates LP39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

4343 W Camp Wisdom Rd
Ste 102
Dallas, TX 75237
Phone (972) 572-3552

Practitioners & affiliated clinicians

Practitioners 3

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1063630465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP S STE 650",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012997",
            "telephone_number": "713-663-7960",
            "fax_number": "713-349-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W CAMP WISDOM RD STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372467",
            "telephone_number": "972-572-3552",
            "fax_number": "972-572-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS DENTAL ASSOCIATE, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "GOMEL",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OFFICER/PARTNER",
        "authorized_official_telephone_number": "713-663-7960",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.