Organization Active NPI

Omega OB-GYN Associates of South Arlington

  • Specialist
  • Arlington, TX
National Provider Identifier
1154325850
Registry record updated Jan 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OMEGA OB-GYN ASSOCIATES OF SOUTH ARLINGTON
Practice address
3201 Matlock Rd Ste 350
Arlington, TX 76015-2954
Phone
(817) 468-3255
Fax
(817) 468-7823
NPI assigned
Jun 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2026

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

Authorized official

Name
Kevin R Gordon, MDNPI 1871597666
Title
Partner
Phone
(817) 468-3255

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 Primary

Addresses

Primary practice location

3201 Matlock Rd Ste 350
Arlington, TX 76015-2954

Mailing address

3201 Matlock Rd Ste 350
Arlington, TX 76015-2954
Phone (817) 468-3255

Other identifiers 1

IdentifierTypeStateIssuer
192556201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050426001199 TX Part B Supplier - Clinic/Group Practice 9335188606 Receives reassigned benefits from 6 practitioners
Practice locations: Arlington, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0484674Omega OB-GYN Associates3201 Matlock Rd Suite 350, Arlington, TX 76015Provider-performed microscopyJan 2, 2027

National Provider Directory

National Provider Directory

Locations

3201 Matlock Rd
Ste 350
Arlington, TX 76015
Phone (817) 468-3255

2912 Kraft St
Ste 30
Arlington, TX 76010
Phone (817) 522-5138

505 Omega Dr
Arlington, TX 76014
Phone (817) 468-3255

1200 Highway 287 N
Mansfield, TX 76063

1200 Highway 287 N
Ste 103
Mansfield, TX 76063
Phone (817) 468-3255

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20865/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767484800000",
    "number": "1154325850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 MATLOCK RD STE 350",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152954",
            "telephone_number": "817-468-3255",
            "fax_number": "817-468-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 MATLOCK RD STE 350",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152954",
            "telephone_number": "817-468-3255",
            "fax_number": "817-468-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA OB-GYN ASSOCIATES OF SOUTH ARLINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2026-01-04",
        "certification_date": "2026-01-04",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "817-468-3255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192556201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2026; 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.