Texas Health Care, P.L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TEXAS HEALTH CARE, P.L.L.C.

Practice address

1622 8TH Avenue
Suite 110
Fort Worth, TX 76104-4155

Phone

(817) 926-2561

Fax

(817) 921-3708

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Larry D. Tatum, M.D.

Title

C.E.O.

Phone

(817) 740-8400

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 13

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

• Errol B. Bryce, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1427077494
  NPD (past)
• Charles A Carlton, MD

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1003820572
  NPD (past)
• Norman Alan Davenport, MD

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1194739664
  NPD (past)
• Haley S. Diatto, PA

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1760814719
  NPD (past)
• Kira Ingrid Haydon, M.D.

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1134419120
  NPD (past)
• Laura S. Kunkel, MSN, APRN, NP-C

  • Nurse Practitioner
  • Fort Worth, TX
  • NPI 1740688563
  NPD (past)
• Jason S. Ledbetter, M.D.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1790702314
  NPD (past)
• Amber Marie Lesley, MD

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1679782908
  NPD (past)
• John F Lucas III, MD

  • Family Medicine Physician
  • Graham, TX
  • NPI 1205803301
  NPD (past)
• Kimberly Phillips Mizener, FNP

  • Nurse Practitioner
  • Fort Worth, TX
  • NPI 1174860597
  NPD (past)
• Andrew Carter Thomas, DO

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1710623301
  NPD (past)
• Angela Winstead

  • Nurse Practitioner
  • Fort Worth, TX
  • NPI 1033515267
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1124185814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-378-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 8TH AVENUE",
            "address_2": "SUITE 110",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044155",
            "telephone_number": "817-926-2561",
            "fax_number": "817-921-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HEALTH CARE, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "TATUM",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "817-740-8400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155109501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0900927",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.
• Texas Health Care, P.L.L.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.