Texas Specialty Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TEXAS SPECIALTY CLINIC

Practice address

2700 W Pleasant Run Rd
Lancaster, TX 75146-1079

Phone

(888) 871-1883

Fax

(888) 900-4530

NPI assigned

Feb 13, 2018

Reactivated

Mar 22, 2024

Last updated

Mar 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raj Kumar

Title

Ceo

Phone

(469) 297-5321

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 8

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.

• Nicholaos C Bellos, MD

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1962471128
  Medicare reassignment
• Ismail Boodhwani Jr., FNP-C

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1033685680
  Medicare reassignment
• Madison Shayne Flores, PA-C

  • Physician Assistant
  • Odessa, TX
  • NPI 1942811914
  Medicare reassignment
• Tenicia Jones, FNP-C

  • Family Nurse Practitioner
  • Lancaster, TX
  • NPI 1396051132
  Medicare reassignment
• Victoria Michelle Campbell, FNP-C

  • Family Nurse Practitioner
  • Midland, TX
  • NPI 1831729193
  NPD (past)
• Padmaja Doniparthi, M.D.

  • Interventional Pain Medicine Physician
  • Rowlett, TX
  • NPI 1437132198
  NPD (past)
• Michael Olaleye Olatunji, M.D.

  • Internal Medicine Physician
  • Frisco, TX
  • NPI 1750303863
  NPD (past)
• Catana Ilegia Villarreal, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Hillsboro, TX
  • NPI 1912582610
  NPD (past)

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1154821429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W PLEASANT RUN RD",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461079",
            "telephone_number": "888-871-1883",
            "fax_number": "888-900-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W PLEASANT RUN RD",
            "city": "LANCASTER",
            "state": "TX",
            "postal_code": "751461079",
            "telephone_number": "888-871-1883",
            "fax_number": "888-900-4530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6407 S Cooper St Ste 133",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760016795",
            "country_code": "US",
            "telephone_number": "817-472-7601",
            "fax_number": "817-472-1723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2603 Oak Lawn Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752194059",
            "country_code": "US",
            "telephone_number": "888-871-1883",
            "fax_number": "888-900-4530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2949 Martin Luther King Jr Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752156319",
            "country_code": "US",
            "telephone_number": "888-871-1883",
            "fax_number": "888-900-4530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS SPECIALTY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2024-03-22",
        "certification_date": "2020-01-23",
        "deactivation_date": "2024-03-06",
        "reactivation_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-297-5321"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Lee Terrell
• Isac Tesfyaye, RPH
• Texas Em-1 Medical Services, PA
• Texas Emergency Room Services, PA
• Texas Mental Health & Behavior LLC
• Bhavya Ashish Thakkar
• The Bagby Way, Inc
• The Divine Care Services - L.L.C
• The Full Fruit Ministries, Inc
• The Full Fruit Ministries,Inc

• Family Medicine Physician in Lancaster, TX
• Providers in Lancaster, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.