NPIMap

Organization Active NPI

DFW Medical Home PLLC

Doing business as Texas Physician House Calls PLLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Irving, TX
National Provider Identifier
1124441423
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DFW MEDICAL HOME PLLC
Doing business as
Texas Physician House Calls PLLC
Practice address
2925 Skyway Cir N
Irving, TX 75038-3510
Phone
(972) 675-7313
Fax
(972) 675-7310
NPI assigned
Jan 23, 2014
Last updated
Feb 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Authorized official

Name
Dr. Sumana Ketha, MDNPI 1962447805
Title
Owner
Phone
(972) 639-5838

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
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

2925 Skyway Cir N
Irving, TX 75038-3510

Mailing address

2925 Skyway Cir N
Irving, TX 75038-3510
Phone (972) 675-7313

Other names 1

  • Texas Physician House Calls PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140710000100 TX Part B Supplier - Clinic/Group Practice 8921223843 Receives reassigned benefits from 11 practitioners
Practice locations: Irving, TX

National Provider Directory

National Provider Directory

Locations

2925 Skyway Cir N
#P
Irving, TX 75038
Phone (972) 675-7313

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1124441423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 SKYWAY CIR N",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383510",
            "telephone_number": "972-675-7313",
            "fax_number": "972-675-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 SKYWAY CIR N",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383510",
            "telephone_number": "972-675-7313",
            "fax_number": "972-675-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFW MEDICAL HOME PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "KETHA",
        "authorized_official_first_name": "SUMANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-639-5838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Physician House Calls PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.