Organization Active NPI

Hippomed Medical Group

  • Clinic/Center
  • Southlake, TX
National Provider Identifier
1104685361
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
HIPPOMED MEDICAL GROUP
Practice address
903 Edgemeer LN
Southlake, TX 76092-1700
Phone
(833) 463-2363
Fax
(833) 226-5805
NPI assigned
Mar 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Mr. Christopher Brown
Title
Office Manager
Phone
(833) 463-2363

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

903 Edgemeer LN
Southlake, TX 76092-1700

Mailing address

903 Edgemeer LN
Southlake, TX 76092-1700
Phone (833) 463-2363

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1104685361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 EDGEMEER LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921700",
            "telephone_number": "833-463-2363",
            "fax_number": "833-226-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 EDGEMEER LN",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921700",
            "telephone_number": "833-463-2363",
            "fax_number": "833-226-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIPPOMED MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "833-463-2363",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.