NPIMap

Organization Active NPI

Primacare Medical Centers

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1104905728
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M4734 Issued in TX
Legal business name
PRIMACARE MEDICAL CENTERS
Practice address
11910 Greenville Ave
Suite 500
Dallas, TX 75243-3596
Phone
(214) 572-1124
Fax
(214) 572-7724
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rebecca Whitney, CPC
Title
Physician Services Manager
Phone
(214) 572-1124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X M4734 TX Primary

Addresses

Primary practice location

11910 Greenville Ave
Suite 500
Dallas, TX 75243-3596

Mailing address

11910 Greenville Ave
Suite 500
Dallas, TX 75243-3596
Phone (214) 572-1124

National Provider Directory

National Provider Directory

Locations

11910 Greenville Ave
Ste 500
Dallas, TX 75243
Phone (214) 343-0058

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104905728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "214-572-1124",
            "fax_number": "214-572-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMACARE MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PHYSICIAN SERVICES MANAGER",
        "authorized_official_telephone_number": "214-572-1124",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4734",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.