Organization Active NPI

Theresa D. Stretch MD, PA

  • Internal Medicine Physician
  • Arlington, TX
National Provider Identifier
1154622678
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N6692 Issued in TX
Legal business name
THERESA D. STRETCH MD, PA
Practice address
1806 W Pleasant Ridge Rd
Arlington, TX 76015-4530
Phone
(817) 635-6363
Fax
(817) 635-6362
NPI assigned
Nov 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Authorized official

Name
Dr. Theresa Deleon Stretch, M.D.NPI 1710218169
Title
Owner
Phone
(817) 635-6363

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X N6692 TX Primary

Addresses

Primary practice location

1806 W Pleasant Ridge Rd
Arlington, TX 76015-4530

Mailing address

1806 W Pleasant Ridge Rd
Arlington, TX 76015-4530
Phone (817) 635-6363

Other identifiers 1

IdentifierTypeStateIssuer
8CQ845OtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110124000534 TX Part B Supplier - Clinic/Group Practice 3476732496 Receives reassigned benefits from 12 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
45D2017830Theresa Stretch MD PA1806 Pleasant Ridge, Arlington, TX 76015Certificate of waiverDec 19, 2026

National Provider Directory

National Provider Directory

Locations

1806 W Pleasant Ridge Rd
Arlington, TX 76015
Phone (817) 635-6363

Practitioners & affiliated clinicians

Practitioners 12

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": "1289779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1154622678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 W PLEASANT RIDGE RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760154530",
            "telephone_number": "817-635-6363",
            "fax_number": "817-635-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W PLEASANT RIDGE RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760154530",
            "telephone_number": "817-635-6363",
            "fax_number": "817-635-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA D. STRETCH MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-15",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "STRETCH",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "DELEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-635-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N6692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CQ845",
            "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 May 18, 2012; 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.