Organization Active NPI

Texas Minimally Invasive Surgery Center, PA

  • Surgery Physician
  • Duncanville, TX
National Provider Identifier
1194953067
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
N2844 Issued in TX
Legal business name
TEXAS MINIMALLY INVASIVE SURGERY CENTER, PA
Practice address
1010 E Wheatland Rd
Duncanville, TX 75116-4905
Phone
(972) 298-4622
Fax
(972) 298-4633
NPI assigned
Jun 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Dr. Anil Kumar Tibrewal, MDNPI 1043259765
Title
President
Phone
(972) 298-4622

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X N2844 TX Primary

Addresses

Primary practice location

1010 E Wheatland Rd
Duncanville, TX 75116-4905

Mailing address

1010 E Wheatland Rd
Duncanville, TX 75116-4905
Phone (972) 298-4622

Other identifiers 2

IdentifierTypeStateIssuer
0080SMOtherTXBLUE CROSS & BLUE SHIELD
203725101MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090805000335 TX Part B Supplier - Clinic/Group Practice 5294888434 Receives reassigned benefits from 1 practitioner
Practice locations: Duncanville, TX

National Provider Directory

National Provider Directory

Locations

3430 W Wheatland Rd
Ste 207
Dallas, TX 75237
Phone (972) 296-8888

2727 Bolton Boone Dr
Ste 108
Desoto, TX 75115
Phone (214) 942-0881

1010 E Wheatland Rd
Duncanville, TX 75116
Phone (972) 296-6912

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1194953067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E WHEATLAND RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164905",
            "telephone_number": "972-298-4622",
            "fax_number": "972-298-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E WHEATLAND RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164905",
            "telephone_number": "972-298-4622",
            "fax_number": "972-298-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS MINIMALLY INVASIVE SURGERY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "TIBREWAL",
        "authorized_official_first_name": "ANIL",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-298-4622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "N2844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "0080SM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203725101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.