Active NPI
Dragon Family Medicine PA
- Family Medicine Physician
- Round Rock, TX
National Provider Identifier
1215002803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- J6637
- Legal business name
- DRAGON FAMILY MEDICINE PA
- Practice address
- 2000 South Ih 35
#E1
Round Rock, TX 78681 - Phone
- (512) 244-1978
- Fax
- (512) 244-0787
- NPI assigned
- Nov 21, 2006
- Last updated
- Jan 31, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan C Miller
- Title
- Admin Asst
- Phone
- (512) 225-6345
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | J6637 | Primary |
Addresses
Primary practice location
2000 South Ih 35
#E1
Round Rock, TX 78681
Mailing address
2000 South Ih 35
#E1
Round Rock, TX 78681
Phone (512) 225-6345
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002EV | Other | BCBS | |
| 141571301 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
2000 S Interstate 35
Ste E1
Round Rock, TX 78681
Phone (512) 244-1978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1359590400000",
"number": "1215002803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 SOUTH IH 35",
"address_2": "#E1",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78681",
"telephone_number": "512-225-6345",
"fax_number": "512-692-5205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 SOUTH IH 35",
"address_2": "#E1",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "78681",
"telephone_number": "512-244-1978",
"fax_number": "512-244-0787"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DRAGON FAMILY MEDICINE PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-21",
"last_updated": "2013-01-31",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "ADMIN ASST",
"authorized_official_telephone_number": "512-225-6345"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": "J6637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0002EV",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "141571301",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.