NPIMap

Organization Active NPI

Texas Vascular Associates

  • Vascular Surgery Physician
  • Dallas, TX
National Provider Identifier
1194718429
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
TEXAS VASCULAR ASSOCIATES
Practice address
621 N. Hall St.
Suite 100
Dallas, TX 75226-1339
Phone
(214) 821-9600
Fax
(214) 823-5449
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Authorized official

Name
Dr. Gregory J Pearl, MDNPI 1720041783
Title
Vascular Surgeon
Phone
(214) 821-9600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X TX Primary
Prosthetic/Orthotic Supplier 335E00000X TX

Addresses

Primary practice location

621 N. Hall St.
Suite 100
Dallas, TX 75226-1339

Mailing address

621 N Hall St
Suite 100
Dallas, TX 75226-1339
Phone (214) 821-9600

Other identifiers 1

IdentifierTypeStateIssuer
143448201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040612000079 TX Part B Supplier - Clinic/Group Practice 4688657380 Receives reassigned benefits from 20 practitioners
Practice locations: Garland, TX; Waxahachie, TX; Richardson, TX; Plano, TX; McKinney, TX; Mansfield, TX; Irving, TX; Dallas, TX

National Provider Directory

National Provider Directory

Locations

621 N Hall St
Ste 100
Dallas, TX 75226
Phone (214) 820-0600

3600 Gaston Ave
Ste 506
Dallas, TX 75246
Phone (214) 821-2274

221 W Colorado Blvd
Ste 825
Dallas, TX 75208
Phone (214) 942-5222

4716 Alliance Blvd
Ste 200
Plano, TX 75093
Phone (972) 665-9100

1305 W Jefferson St
Ste 100
Waxahachie, TX 75165
Phone (469) 800-9400

1626 W Highway 287 Business
Ste 102
Waxahachie, TX 75165
Phone (972) 923-2600

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1194718429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 N HALL ST",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261339",
            "telephone_number": "214-821-9600",
            "fax_number": "214-823-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N. HALL ST.",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261339",
            "telephone_number": "214-821-9600",
            "fax_number": "214-823-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS VASCULAR ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "PEARL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VASCULAR SURGEON",
        "authorized_official_telephone_number": "214-821-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143448201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.