NPIMap

Organization Active NPI

Functional Recovery Associates, PLLC

  • Specialist
  • Dallas, TX
National Provider Identifier
1235532425
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G1105 Issued in TX
Legal business name
FUNCTIONAL RECOVERY ASSOCIATES, PLLC
Practice address
5701 Maple Ave Ste 100
Dallas, TX 75235-6596
Phone
(214) 351-6600
NPI assigned
Oct 1, 2014
Last updated
Apr 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Authorized official

Name
Tom G Mayer, M.DNPI 1629034137
Title
President
Phone
(214) 520-9163

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G1105 TX Primary

Addresses

Primary practice location

5701 Maple Ave Ste 100
Dallas, TX 75235-6596

Mailing address

5701 Maple Ave Ste 100
Dallas, TX 75235-6596
Phone (214) 351-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019000563 TX Part B Supplier - Clinic/Group Practice 4587973383 Receives reassigned benefits from 7 practitioners
Practice locations: Austin, TX; Dallas, TX; Ft Worth, TX

National Provider Directory

National Provider Directory

Locations

5701 Maple Ave
Ste 330
Dallas, TX 75235

7929 Brookriver Dr
Ste 400
Dallas, TX 75247
Phone (214) 351-6600

6000 Western Pl
Ste 501
Ft Worth, TX 76107
Phone (214) 351-6600

1101 S Capital of Texas Hwy
Bldg J-100
West Lake Hills, TX 78746
Phone (214) 420-7800

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1235532425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 MAPLE AVE STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752356596",
            "telephone_number": "214-351-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 MAPLE AVE STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752356596",
            "telephone_number": "214-351-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL RECOVERY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-520-9163",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "G1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.