Promontory Geriatrics LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

J6337 Issued in TX

Legal business name

PROMONTORY GERIATRICS LLC

Practice address

2727 Bolton Boone Dr Ste 114
Desoto, TX 75115-2019

Phone

(469) 857-3142

Fax

(469) 857-3077

NPI assigned

May 20, 2010

Organization subpart

No

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

Authorized official

Name

Gene O BighamNPI 1538126719

Title

Managing Officer

Phone

(469) 857-3142

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Gene O. Bigham, M.D.

  • Internal Medicine Physician
  • Desoto, TX
  • NPI 1538126719
  Medicare reassignment Care Compare group NPD Authorized official
• Suzana Chau Tran, FNP

  • Family Nurse Practitioner
  • Desoto, TX
  • NPI 1093873358
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1194044792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 BOLTON BOONE DR STE 114",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152019",
            "telephone_number": "469-857-3142",
            "fax_number": "469-857-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 BOLTON BOONE DR STE 114",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152019",
            "telephone_number": "469-857-3142",
            "fax_number": "469-857-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMONTORY GERIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-20",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "BIGHAM",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MANAGING OFFICER",
        "authorized_official_telephone_number": "469-857-3142"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J6337",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.