NPIMap

Organization Active NPI

Cross Timbers ENT PLLC

  • Specialist
  • Arlington, TX
National Provider Identifier
1073568127
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G2176 Issued in TX
Legal business name
CROSS TIMBERS ENT PLLC
Practice address
400 West Arbrook B;LVD
Suite 301
Arlington, TX 76014-3174
Phone
(817) 261-3000
Fax
(817) 274-4292
NPI assigned
May 24, 2006
Last updated
Nov 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Authorized official

Name
Ms. Stacey L Conant, COPM
Title
Office Manager
Phone
(817) 261-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G2176 TX Primary

Addresses

Primary practice location

400 West Arbrook B;LVD
Suite 301
Arlington, TX 76014-3174

Mailing address

400 West Arbrook Blvd
Suite 301
Arlington, TX 76014-3174
Phone (817) 261-3000

Other identifiers 1

IdentifierTypeStateIssuer
080303301MedicaidTX

Other names 1

  • Cross Timbers Ear, Nose & Throat, PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081216000319 TX Part B Supplier - Clinic/Group Practice 9234291840 Receives reassigned benefits from 14 practitioners
Practice locations: Arlington, TX; Mansfield, TX; Midlothian, TX

National Provider Directory

National Provider Directory

Locations

400 W Arbrook Blvd
Ste 301
Arlington, TX 76014
Phone (817) 261-3000

801 E Debbie Ln
Ste 200
Mansfield, TX 76063

2021 S 14th St
Bldg A
Midlothian, TX 76065

2220 Bryan Pl
Ste 100
Midlothian, TX 76065

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1073568127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WEST ARBROOK BLVD",
            "address_2": "SUITE 301",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143174",
            "telephone_number": "817-261-3000",
            "fax_number": "817-274-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WEST ARBROOK B;LVD",
            "address_2": "SUITE 301",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760143174",
            "telephone_number": "817-261-3000",
            "fax_number": "817-274-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS TIMBERS ENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "CONANT",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-261-3000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "COPM"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G2176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080303301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Timbers Ear, Nose & Throat, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.