NPIMap

Organization Active NPI

DFW Plastic Surgery

  • Specialist
  • Grapevine, TX
National Provider Identifier
1124277488
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G4836 Issued in TX
Legal business name
DFW PLASTIC SURGERY
Practice address
1600 W College St
Ste. 380
Grapevine, TX 76051-3580
Phone
(817) 481-0868
Fax
(817) 481-1378
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Authorized official

Name
Dr. Robert C Bledsoe, M.D.NPI 1396817409
Title
Dr.
Phone
(817) 481-0868

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G4836 TX Primary

Addresses

Primary practice location

1600 W College St
Ste. 380
Grapevine, TX 76051-3580

Mailing address

1600 W College St
Ste. 380
Grapevine, TX 76051-3580
Phone (817) 481-0868

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1124277488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "STE. 380",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513580",
            "telephone_number": "817-481-0868",
            "fax_number": "817-481-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "STE. 380",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513580",
            "telephone_number": "817-481-0868",
            "fax_number": "817-481-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFW PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "BLEDSOE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "817-481-0868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "G4836",
            "primary": true
        }
    ],
    "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 Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.