Organization Active NPI

North Texas Medical Surgical Clinic PA

  • Family Medicine Physician
  • Denton, TX
National Provider Identifier
1114019783
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTH TEXAS MEDICAL SURGICAL CLINIC PA
Practice address
2509 Scripture St
Ste 200
Denton, TX 76201-2337
Phone
(940) 898-7400
Fax
(940) 387-7327
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Thomas O Blucker, MD
Title
Chairman
Phone
(940) 898-7400

Specialties & licenses 1

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

Addresses

Primary practice location

2509 Scripture St
Ste 200
Denton, TX 76201-2337

Mailing address

2509 Scripture St
Ste 200
Denton, TX 76201-2337
Phone (940) 898-7400

Other identifiers 1

IdentifierTypeStateIssuer
0819997 01MedicaidTX

National Provider Directory

National Provider Directory

Locations

2509 Scripture St
Ste 200
Denton, TX 76201
Phone (940) 898-7400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1114019783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 SCRIPTURE ST",
            "address_2": "STE 200",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012337",
            "telephone_number": "940-898-7400",
            "fax_number": "940-387-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 SCRIPTURE ST",
            "address_2": "STE 200",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762012337",
            "telephone_number": "940-898-7400",
            "fax_number": "940-387-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS MEDICAL SURGICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "BLUCKER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "940-898-7400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0819997 01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.