Ihde Surgical Group, PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

IHDE SURGICAL GROUP, PA

Practice address

515 W. Mayfield
Suite 402
Arlington, TX 76014

Phone

(817) 467-3000

Fax

(817) 467-3001

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Michael Ihde II, MD

Title

President

Phone

(817) 467-3000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1255426714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W. MAYFIELD",
            "address_2": "SUITE 402",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76014",
            "telephone_number": "817-467-3000",
            "fax_number": "817-467-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W. MAYFIELD",
            "address_2": "SUITE 402",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76014",
            "telephone_number": "817-467-3000",
            "fax_number": "817-467-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHDE SURGICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "IHDE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-467-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.