Individual provider Active NPI

Raechel Pauline Paterson, PA

  • Medical Physician Assistant
  • Dallas, TX
National Provider Identifier
1063788685
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA07731 Issued in TX
Practice address
18101 Preston Rd Ste 201
Dallas, TX 75252
Phone
(972) 584-9444
NPI assigned
Mar 28, 2012
Last updated
May 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA07731 TX Primary

Addresses

Primary practice location

18101 Preston Rd Ste 201
Dallas, TX 75252

Mailing address

18101 Preston Rd Ste 201
Dallas, TX 75252-5473
Phone (972) 584-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140812001897 TX Practitioner - Physician Assistant 7810114014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

5232 Colleyville Blvd
Suite 100
Colleyville, TX 76034-7827
Phone (817) 912-9920

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

5800 E Lovers LN
Dallas, TX 75206-2901
Phone (972) 817-6260

7217 Telecom Pkwy
Garland, TX 75044-2203

925 E Southlake Boulevard
100 Baylor Scott and White Urgent Care Southl
Southlake, TX 76092-1477
Phone (817) 912-8560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA07731TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 19, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 19, 2019 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1063788685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18101 PRESTON RD STE 201",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525473",
            "telephone_number": "972-584-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 PRESTON RD STE 201",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75252",
            "telephone_number": "972-584-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERSON",
        "first_name": "RAECHEL",
        "middle_name": "PAULINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA07731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.