Organization Active NPI

Live Dry LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Irving, TX
National Provider Identifier
1235302274
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
G0320 Issued in TX
Legal business name
LIVE DRY LLC
Practice address
3501 N Macarthur Blvd
Suite 350
Irving, TX 75062-3636
Phone
(972) 257-5300
Fax
(972) 257-5321
NPI assigned
Apr 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
John V Gregg
Title
Vice President
Phone
(817) 896-0860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X G0320 TX Primary

Addresses

Primary practice location

3501 N Macarthur Blvd
Suite 350
Irving, TX 75062-3636

Mailing address

3501 N Macarthur Blvd
Suite 350
Irving, TX 75062-3636
Phone (972) 257-5300

National Provider Directory

National Provider Directory

Locations

4020 N MacArthur Blvd
#122238
Irving, TX 75038

Practitioners & affiliated clinicians

Practitioners 2

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": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1235302274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD",
            "address_2": "SUITE 350",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623636",
            "telephone_number": "972-257-5300",
            "fax_number": "972-257-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N MACARTHUR BLVD",
            "address_2": "SUITE 350",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750623636",
            "telephone_number": "972-257-5300",
            "fax_number": "972-257-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE DRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "GREGG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "817-896-0860"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "G0320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.