NPIMap

Organization Active NPI

Bent Tree Family Physician, PA

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1124180120
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BENT TREE FAMILY PHYSICIAN, PA
Practice address
17110 Dallas Pkwy
Suite 100
Dallas, TX 75248-1167
Phone
(972) 380-7000
Fax
(972) 380-9266
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Dr. Guy Lee Culpepper, M.D.NPI 1407849052
Title
President
Phone
(972) 380-7000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

17110 Dallas Pkwy
Suite 100
Dallas, TX 75248-1167

Mailing address

17110 Dallas Pkwy
Suite 100
Dallas, TX 75248-1167
Phone (972) 380-7000

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0481754Bent Tree Family Physicians17110 Dallas Parkway Suite 100, Dallas, TX 75248AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

4221 Medical Pkwy
Ste 550
Carrollton, TX 75010
Phone (972) 820-1000

17110 Dallas Pkwy
Ste 100A
Dallas, TX 75248
Phone (972) 380-7000

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1124180120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17110 DALLAS PKWY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481167",
            "telephone_number": "972-380-7000",
            "fax_number": "972-380-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17110 DALLAS PKWY",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481167",
            "telephone_number": "972-380-7000",
            "fax_number": "972-380-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENT TREE FAMILY PHYSICIAN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "CULPEPPER",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-380-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.