NPIMap

Organization Active NPI

North Texas Excel Physicians PLLC

  • Emergency Care Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1124484233
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
N0192 Issued in TX
Legal business name
NORTH TEXAS EXCEL PHYSICIANS PLLC
Practice address
4561 Heritage Trace Parkway
Fort Worth, TX 76244
Phone
(817) 753-7911
NPI assigned
Jan 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Authorized official

Name
Christopher Kwon, MD
Title
Director
Phone
(817) 753-7911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X N0192 TX Primary

Addresses

Primary practice location

4561 Heritage Trace Parkway
Fort Worth, TX 76244

Mailing address

PO Box 60962
Corpus Christi, TX 78466-0962
Phone (361) 884-2904

Other identifiers 1

IdentifierTypeStateIssuer
N0192OtherTXMEDICAL LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1124484233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60962",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784660962",
            "telephone_number": "361-884-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4561 HERITAGE TRACE PARKWAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-753-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS EXCEL PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-753-7911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "N0192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "N0192",
            "state": "TX"
        }
    ],
    "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 Jul 6, 2016; 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.