Active NPI
Texas Healthy Aging and Hormone Therapy LLC
- Family Medicine Physician
- Mineral Wells, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- TEXAS HEALTHY AGING AND HORMONE THERAPY LLC
- Practice address
- 202 SW 25TH Ave
Suite 1200
Mineral Wells, TX 76067-8298 - Phone
- (940) 325-3706
- Fax
- (940) 325-6200
- NPI assigned
- Mar 14, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lori Shae Hopper, APN-C
- Title
- Sole MBR
- Phone
- (940) 325-3706
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
202 SW 25TH Ave
Suite 1200
Mineral Wells, TX 76067-8298
Mailing address
202 SW 25TH Ave
Suite 1200
Mineral Wells, TX 76067-8298
Phone (940) 325-3706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170519001259 | TX | Part B Supplier - Clinic/Group Practice | 9638446701 |
Receives reassigned benefits from 6 practitioners Practice locations: Mineral Wells, TX |
National Provider Directory
National Provider DirectoryLocations
202 SW 25th Ave
Ste 1200
Mineral Wells, TX 76067
Phone (940) 325-3706
2517 Highway 180 W
Ste A
Mineral Wells, TX 76067
Phone (940) 325-3706
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Mineral Wells, TX
- NPI 1255070348
Multi-Specialty, TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489449600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1489449600000",
"number": "1245771963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 SW 25TH AVE",
"address_2": "SUITE 1200",
"city": "MINERAL WELLS",
"state": "TX",
"postal_code": "760678298",
"telephone_number": "940-325-3706",
"fax_number": "940-325-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 SW 25TH AVE",
"address_2": "SUITE 1200",
"city": "MINERAL WELLS",
"state": "TX",
"postal_code": "760678298",
"telephone_number": "940-325-3706",
"fax_number": "940-325-6200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEXAS HEALTHY AGING AND HORMONE THERAPY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-14",
"last_updated": "2017-03-14",
"status": "A",
"authorized_official_last_name": "HOPPER",
"authorized_official_first_name": "LORI",
"authorized_official_middle_name": "SHAE",
"authorized_official_title_or_position": "SOLE MBR",
"authorized_official_telephone_number": "940-325-3706",
"authorized_official_credential": "APN-C"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mineral Wells, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.