Individual provider Active NPI

Teresa Janelle Bascom, M.D.

  • Obstetrics & Gynecology Physician
  • Dallas, TX
National Provider Identifier
1275535049
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
L0021 Issued in TX
Practice address
1441 N Beckley Ave
Dallas, TX 75203-1201
Phone
(214) 947-8181
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X L0021 TX Primary

Addresses

Primary practice location

1441 N Beckley Ave
Dallas, TX 75203-1201

Mailing address

1441 N. Beckley Ave.
Medical Education
Dallas, TX 75203
Phone (214) 947-2331

Other practice location 1

122 W Colorado Blvd
Dallas, TX 75208-2382
Phone (214) 947-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080606000080 TX Practitioner - Obstetrics/Gynecology 3678518438 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced OB-GYN Associates P.a. Obstetrics & Gynecology CurrentSince Apr 1, 2008 Accepting new patients
Physician Associates of Southwest Dallas Obstetrics & Gynecology CurrentSince Oct 29, 2018 Accepting new patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Jun 14, 2016 Accepting new patients
Health Central, P.a. Past Accepting new patients

Locations

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

122 W Colorado Blvd
Dallas, TX 75208
Phone (214) 947-6555

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

3201 George Bush Hwy
Ste 107
Richardson, TX 75082
Phone (972) 276-9902

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1275535049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N. BECKLEY AVE.",
            "address_2": "MEDICAL EDUCATION",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75203",
            "telephone_number": "214-947-2331",
            "fax_number": "214-947-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031201",
            "telephone_number": "214-947-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 W Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752082382",
            "country_code": "US",
            "telephone_number": "214-947-6700",
            "fax_number": "214-947-6701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASCOM",
        "first_name": "TERESA",
        "middle_name": "JANELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L0021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.