NPIMap

Organization Active NPI

Paul S. Worrell, D.O., P.a.

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1093925620
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
F7329 Issued in TX
Legal business name
PAUL S. WORRELL, D.O., P.A.
Practice address
8668 Skillman St
Dallas, TX 75243-8216
Phone
(214) 349-4909
Fax
(214) 349-4973
NPI assigned
May 23, 2007
Last updated
Apr 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Authorized official

Name
Mr. Freddie Tomblin
Title
Office Manager
Phone
(214) 349-4909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X F7329 TX Primary

Addresses

Primary practice location

8668 Skillman St
Dallas, TX 75243-8216

Mailing address

8668 Skillman Street
Dallas, TX 75243
Phone (214) 349-4909

Other identifiers 1

IdentifierTypeStateIssuer
SJ05OtherTXMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141024001222 TX Part B Supplier - Clinic/Group Practice 9830310465 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

8668 Skillman St
Dallas, TX 75243
Phone (214) 349-4909

Practitioners & affiliated clinicians

Practitioners 12

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": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1093925620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8668 SKILLMAN STREET",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "214-349-4909",
            "fax_number": "214-349-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8668 SKILLMAN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752438216",
            "telephone_number": "214-349-4909",
            "fax_number": "214-349-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL S. WORRELL, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "TOMBLIN",
        "authorized_official_first_name": "FREDDIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-349-4909",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "F7329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SJ05",
            "state": "TX"
        }
    ],
    "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 Apr 9, 2014; 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.