NPIMap

Organization Active NPI

Medical Group of Texas PLLC

  • Physiological Laboratory
  • Allen, TX
National Provider Identifier
1275134199
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
MEDICAL GROUP OF TEXAS PLLC
Practice address
825 Watters Creek Blvd Ste 250
Allen, TX 75013-3770
Phone
(918) 550-3552
NPI assigned
Nov 6, 2020
Organization subpart
Yes
Parent organization
MEDICAL GROUP OF TEXAS PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
Jeff Scott Brouwer
Title
Owner
Phone
(602) 249-0999

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Physiological Laboratory 293D00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

825 Watters Creek Blvd Ste 250
Allen, TX 75013-3770

Mailing address

825 Watters Creek Blvd Ste 250
Allen, TX 75013-3770
Phone (918) 550-3552

National Provider Directory

National Provider Directory
Tax ID family
Medical Group of Texas PLLC2 organizations share this tax ID, including this one
Part of
Medical Group of Texas PLLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1275134199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WATTERS CREEK BLVD STE 250",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133770",
            "telephone_number": "918-550-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WATTERS CREEK BLVD STE 250",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133770",
            "telephone_number": "918-550-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GROUP OF TEXAS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL GROUP OF TEXAS PLLC",
        "enumeration_date": "2020-11-06",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "BROUWER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-249-0999"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.