Health Texas Provider Network-Family Practice of North Texas LLP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00997Y Issued in TX

Legal business name

HEALTH TEXAS PROVIDER NETWORK-FAMILY PRACTICE OF NORTH TEXAS LLP

Practice address

1001 12TH Ave
Suite 130
Fort Worth, TX 76104-3926

Phone

(817) 921-6166

Fax

(817) 921-9594

NPI assigned

Aug 16, 2005

Last updated

Feb 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ellen Elizabeth Fourton

Title

Director

Phone

(972) 860-8649

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Brent W Walker, D.O.

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1629084793
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1114919172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 N CENTRAL EXPY",
            "address_2": "SUITE 1650",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752061838",
            "telephone_number": "972-860-8653",
            "fax_number": "972-860-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE",
            "address_2": "SUITE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043926",
            "telephone_number": "817-921-6166",
            "fax_number": "817-921-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH TEXAS PROVIDER NETWORK-FAMILY PRACTICE OF NORTH TEXAS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "FOURTON",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-860-8649",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "00997Y",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Healthsource of Ft Worth-West 7TH

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.