Organization Active NPI

Dragon Family Medicine PA

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1215002803
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0002EVOtherBCBS
141571301MedicaidTX

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.