NPIMap

Organization Active NPI

Greater Dallas Healthcare Enterprises

  • Pediatrics Physician
  • El Paso, TX
National Provider Identifier
1255798385
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GREATER DALLAS HEALTHCARE ENTERPRISES
Practice address
3270 Joe Battle Blvd
Ste. 120
El Paso, TX 79938-2639
Phone
(915) 577-1961
Fax
(915) 577-1962
NPI assigned
Jan 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Authorized official

Name
Mr. Timothy Adams
Title
SVP Regional Operations, Tenet
Phone
(469) 893-2563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3270 Joe Battle Blvd
Ste. 120
El Paso, TX 79938-2639

Mailing address

PO Box 840711
Dallas, TX 75284-0711
Phone (915) 577-1961

Other names 1

  • Providence Medical Partners Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2130467Providence Medical Partners3270 Joe Battle Suite 120, El Paso, TX 79938Certificate of waiverMay 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Greater Dallas Healthcare Enterprises12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

631 N Resler Dr
Ste 101A
El Paso, TX 79912
Phone (915) 842-0676

621 N Resler Dr
Ste 101
El Paso, TX 79912

NPI Registry JSON

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1255798385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840711",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840711",
            "telephone_number": "915-577-1961",
            "fax_number": "915-577-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 JOE BATTLE BLVD",
            "address_2": "STE. 120",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382639",
            "telephone_number": "915-577-1961",
            "fax_number": "915-577-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER DALLAS HEALTHCARE ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SVP REGIONAL OPERATIONS, TENET",
        "authorized_official_telephone_number": "469-893-2563",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Medical Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.