NPIMap

Organization Active NPI

Clinics of North Texas LLP

  • Diagnostic Radiology Physician
  • Wichita Falls, TX
National Provider Identifier
1124007760
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CLINICS OF NORTH TEXAS LLP
Practice address
501 Midwestern Pkwy E
Wichita Falls, TX 76302-2302
Phone
(940) 766-3551
NPI assigned
Jan 12, 2006
Organization subpart
Yes
Parent organization
CLINICS OF NORTH TEXAS LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Dr. Michael Agyepong, MDNPI 1568440758
Title
President
Phone
(940) 397-5490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Nuclear Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207UN0901X
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

501 Midwestern Pkwy E
Wichita Falls, TX 76302-2302

Mailing address

501 Midwestern Pkwy E
Attn: Tracey Terrell
Wichita Falls, TX 76302-2302
Phone (940) 766-3551

Other identifiers 1

IdentifierTypeStateIssuer
1124007760MedicaidTX

Other names 1

  • Clinics of North Texas, LLP - Radiology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080404000508 TX Part B Supplier - Clinic/Group Practice 8820993496 Receives reassigned benefits from 52 practitioners
1 other NPI on this enrollment
Practice locations: Wichita Falls, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clinics of North Texas LLP3 organizations share this tax ID, including this one
Part of
Clinics of North Texas LLP

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4111 Call Field Rd
Wichita Falls, TX 76308
Phone (940) 696-2225

1630 11th St
Wichita Falls, TX 76301

Practitioners & affiliated clinicians

Practitioners 65

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

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1124007760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MIDWESTERN PKWY E",
            "address_2": "ATTN: TRACEY TERRELL",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763022302",
            "telephone_number": "940-766-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MIDWESTERN PKWY E",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763022302",
            "telephone_number": "940-766-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICS OF NORTH TEXAS LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLINICS OF NORTH TEXAS LLP",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "AGYEPONG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-397-5490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124007760",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinics of North Texas, LLP - Radiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.