Pro Physician Clinic PA

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

PRO PHYSICIAN CLINIC PA

Practice address

800 W Magnolia Ave
Fort Worth, TX 76104-4611

Phone

(817) 886-8730

NPI assigned

Oct 2, 2008

Last updated

Oct 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jon Tryggestad

Title

Manager

Phone

(817) 886-8730

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1225289739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N MARKET ST",
            "address_2": "SUITE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752021807",
            "telephone_number": "817-886-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W MAGNOLIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044611",
            "telephone_number": "817-886-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO PHYSICIAN CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "TRYGGESTAD",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-886-8730"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primecrest Psychiatry & Family Wellness PLLC
• Ieisha Prince
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• Pro Health Diagnostics of North Texas PA
• Pro Physicians Clinic PA
• Procare Home Care & Sitter Service Co Inc
• Procare Pharmacy LLC (CVS Pharmacy #02751)
• Procare Pharmacy, LLC (CVS Pharmacy #02751)
• Professional Caretakers Inc.

• Radiation Oncology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Radiation Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.