NPIMap

Individual provider Active NPI

Timothy L Overlock, M.D.

  • Specialist
  • Texarkana, TX
National Provider Identifier
1194722173
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
K3372 Issued in TX
Practice address
1002 Texas Blvd
Ste 201
Texarkana, TX 75501-5107
Phone
(903) 794-3701
Fax
(903) 794-3518
NPI assigned
Jul 5, 2005
Last updated
Mar 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X K3372 TX Primary

Addresses

Primary practice location

1002 Texas Blvd
Ste 201
Texarkana, TX 75501-5107

Mailing address

1002 Texas Blvd
Ste 201
Texarkana, TX 75501-5107
Phone (903) 794-3701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819000657 TX Practitioner - Internal Medicine 0042283707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1002 Texas Blvd
Suite 201
Texarkana, TX 75501-5133
Phone (903) 794-1363

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Specialists of Texarkana Specialist CurrentSince Apr 12, 2005 Accepting new patients
Gabbie Medical Clinic PA Past Accepting new patients
Texarkana Regional Healthcare Network Specialist Past Accepting new patients
Texarkana Emergency Medicine Physicians,PA Past Accepting new patients
Collom and Carney Clinic Association Past Accepting new patients
Norris Knight MD Orthopedics Past Accepting new patients
Betty J. Feir PH.D., P.C. Past Accepting new patients
Healthcare Express, LLP Past Accepting new patients

Locations

1002 Texas Blvd
Ste 201
Texarkana, TX 75501
Phone (903) 794-1363

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0vrdpNH7rwpdKHXHV32pI9kiii8_MVX2/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1194722173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD",
            "address_2": "STE 201",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015107",
            "telephone_number": "903-794-3701",
            "fax_number": "903-794-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 TEXAS BLVD",
            "address_2": "STE 201",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755015107",
            "telephone_number": "903-794-3701",
            "fax_number": "903-794-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERLOCK",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K3372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.