Individual provider Active NPI

Teresa Shook, LSA

  • Surgical Assistant
  • North Richland Hills, TX
National Provider Identifier
1063632297
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
SA000146 Issued in TX
Practice address
4401 Booth Calloway Rd
North Richland Hills, TX 76180-7371
Phone
(972) 404-6884
NPI assigned
Apr 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA000146 TX Primary

Addresses

Primary practice location

4401 Booth Calloway Rd
North Richland Hills, TX 76180-7371

Mailing address

PO Box 295305
Lewisville, TX 75029-5305
Phone (972) 404-6884

Other practice location 1

3101 N Tarrant Pkwy
Fort Worth, TX 76177-8656
Phone (817) 639-1001

Other practice location 2

8900 Medical City Way
Fort Worth, TX 76177-2474
Phone (817) 898-6610

Other practice location 3

4300 City Point Dr
North Richland Hills, TX 76180-8380
Phone (817) 548-4000

Other identifiers 2

IdentifierTypeStateIssuer
0017JROtherTXBCBS
SA00146OtherTXLICENSED SURGICAL ASST

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA000146TXMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1063632297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295305",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750295305",
            "telephone_number": "972-404-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 BOOTH CALLOWAY RD",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807371",
            "telephone_number": "972-404-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 N Tarrant Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761778656",
            "country_code": "US",
            "telephone_number": "817-639-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8900 Medical City Way",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761772474",
            "country_code": "US",
            "telephone_number": "817-898-6610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 City Point Dr",
            "address_purpose": "LOCATION",
            "city": "North Richland Hills",
            "state": "TX",
            "postal_code": "761808380",
            "country_code": "US",
            "telephone_number": "817-548-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "TERESA",
        "credential": "LSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2025-04-01",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA000146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0017JR",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED SURGICAL ASST",
            "identifier": "SA00146",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Richland Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.