Active NPI
Texas Health Care, P.L.L.C.
- Internal Medicine Physician
- Fort Worth, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- 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
- Last updated
- Sep 18, 2009
- 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
- Larry D. Tatum, M.D.
- Title
- C.E.O.
- Phone
- (817) 740-8400
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1622 8TH Avenue
Suite 110
Fort Worth, TX 76104-4155
Mailing address
P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031110000388 | TX | Part B Supplier - Clinic/Group Practice | 7214840867 |
Receives reassigned benefits from 544 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0900927 | Texas Health Care PLLC | Certificate of waiver | Feb 29, 2028 |
National Provider Directory
National Provider DirectoryLocations
1622 8th Ave
Ste 110
Fort Worth, TX 76104
Phone (817) 920-0924
Practitioners & affiliated clinicians
Practitioners 14
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.
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- NPI 1427077494
-
- Internal Medicine Physician
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- NPI 1003820572
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- Internal Medicine Physician
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- NPI 1194739664
-
- Physician Assistant
- Fort Worth, TX
- NPI 1760814719
-
- Family Medicine Physician
- Fort Worth, TX
- NPI 1134419120
-
- Nurse Practitioner
- Fort Worth, TX
- NPI 1740688563
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1790702314
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1679782908
-
- Family Medicine Physician
- Graham, TX
- NPI 1205803301
-
- Nurse Practitioner
- Fort Worth, TX
- NPI 1174860597
-
- Internal Medicine Physician
- Fort Worth, TX
- NPI 1710623301
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- 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.