NPIMap

Organization Active NPI

Physician Assistant Services of Texas L.L.P

  • Medical Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1164467692
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
PHYSICIAN ASSISTANT SERVICES OF TEXAS L.L.P
Practice address
900 8TH Ave
Fort Worth, TX 76104-3902
Phone
(972) 599-0080
Fax
(972) 599-0082
NPI assigned
Jun 18, 2006
Last updated
Jun 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

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

Authorized official

Name
Mr. Lonnie James Ginn, PA-CNPI 1215978226
Title
Owner
Phone
(972) 599-0080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

900 8TH Ave
Fort Worth, TX 76104-3902

Mailing address

PO Box 93175
Southlake, TX 76092-1175
Phone (972) 280-0080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001761 TX Part B Supplier - Clinic/Group Practice 2062303803 Receives reassigned benefits from 26 practitioners
5 other NPIs on this enrollment
Practice locations: Fort Worth, TX; Garland, TX; Irving, TX; Mansfield, TX; North Richland Hills, TX; Plano, TX; Richardson, TX; Waco, TX…

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1164467692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93175",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921175",
            "telephone_number": "972-280-0080",
            "fax_number": "972-280-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043902",
            "telephone_number": "972-599-0080",
            "fax_number": "972-599-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ASSISTANT SERVICES OF TEXAS L.L.P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "GINN",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-599-0080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 6, 2014; 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.