Active NPI
Surgical Group of North Texas, PLLC
- Surgery Physician
- Grapevine, TX
National Provider Identifier
1124085956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- SURGICAL GROUP OF NORTH TEXAS, PLLC
- Practice address
- 1056 Texan TRL
Grapevine, TX 76051-3703 - Phone
- (817) 251-0070
- Fax
- (817) 527-6610
- NPI assigned
- Apr 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sina Matin, M.D.
- Title
- Partner
- Phone
- (817) 251-0070
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | |||
| Surgery Physician | 208600000X | Primary | ||
| Acute Care Nurse Practitioner | 363LA2100X | |||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
1056 Texan TRL
Grapevine, TX 76051-3703
Mailing address
PO Box 204803
Dallas, TX 75320-4803
Phone (817) 251-0070
Other practice location 1
9509 N Beach St Ste 102
Fort Worth, TX 76244-6399
Phone (817) 251-0070
Other practice location 2
12461 Timberland Blvd Ste 301
Fort Worth, TX 76244-5212
Phone (817) 251-0070
National Provider Directory
National Provider DirectoryLocations
12461 Timberland Blvd
Ste 301
Fort Worth, TX 76244
Phone (817) 251-0070
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Irving, TX
- NPI 1932131414
-
- Surgery Physician
- Southlake, TX
- NPI 1972546943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1576195200000",
"number": "1124085956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 204803",
"city": "DALLAS",
"state": "TX",
"postal_code": "753204803",
"telephone_number": "817-251-0070",
"fax_number": "817-527-6610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1056 TEXAN TRL",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760513703",
"telephone_number": "817-251-0070",
"fax_number": "817-527-6610"
}
],
"practiceLocations": [
{
"address_1": "9509 N Beach St Ste 102",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "762446399",
"country_code": "US",
"telephone_number": "817-251-0070",
"fax_number": "817-527-6610",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12461 Timberland Blvd Ste 301",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "762445212",
"country_code": "US",
"telephone_number": "817-251-0070",
"fax_number": "817-527-6610",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SURGICAL GROUP OF NORTH TEXAS, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-26",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A",
"authorized_official_last_name": "MATIN",
"authorized_official_first_name": "SINA",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "817-251-0070",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Acute Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grapevine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.