NPIMap

Organization Active NPI

Tarrant County Infectious Disease Associates

  • Infectious Disease Physician
  • Fort Worth, TX
National Provider Identifier
1225358708
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
TARRANT COUNTY INFECTIOUS DISEASE ASSOCIATES
Practice address
1025 College Ave
Fort Worth, TX 76104-3013
Phone
(817) 806-5173
Fax
(817) 806-5178
NPI assigned
Jun 7, 2010
Last updated
Sep 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Authorized official

Name
Pam Dunaj
Title
Practice Administrator
Phone
(817) 810-9810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

1025 College Ave
Fort Worth, TX 76104-3013

Mailing address

PO Box 162464
Fort Worth, TX 76161-2464

Other identifiers 2

IdentifierTypeStateIssuer
CH8204OtherMEDICARE RR GROUP
00099KOtherTXBCBS GROUP

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCCBBA

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1225358708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 162464",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761612464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043013",
            "telephone_number": "817-806-5173",
            "fax_number": "817-806-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARRANT COUNTY INFECTIOUS DISEASE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-07",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "DUNAJ",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "817-810-9810"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP",
            "identifier": "CH8204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "00099K",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.