Highway 30 Family Medical Center, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HIGHWAY 30 FAMILY MEDICAL CENTER, PA

Practice address

1200 Woodhaven Blvd
Fort Worth, TX 76112-2376

Phone

(817) 429-8300

Fax

(817) 429-6167

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael D Hoffman, DO

Title

Owner/Physician

Phone

81742983000

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1174581912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9991 MARSH LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752201766",
            "telephone_number": "214-358-0090",
            "fax_number": "214-526-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WOODHAVEN BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122376",
            "telephone_number": "817-429-8300",
            "fax_number": "817-429-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHWAY 30 FAMILY MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "81742983000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153458801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153458802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Highland Weight Loss & Wellness Clinic, P.a.
• Victoria Highland, LCSW
• Shanelle Denor Highsmith
• Michael Glenn Hightower, PH.D.
• Nancy E Hightower, PHD
• Janel Higuera
• Robert Scott Hilborn, PH.D.
• Keaton Hildebrand, DC
• Evelyn Louise Hildebrandt, APRN
• Theresa Hilgardner, RPH

• All providers in Fort Worth, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.