Premier Diabetes Endocrinology, PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PREMIER DIABETES ENDOCRINOLOGY, PA

Practice address

4100 Fairway Dr Ste 620
Carrollton, TX 75010-6539

Phone

(972) 492-9901

Fax

(972) 492-9902

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ted Obialo

Title

Manager

Phone

(972) 492-9901

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19764/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adrian Coy Jones, NP-C, D.C.

  • Family Nurse Practitioner
  • Krum, TX
  • NPI 1194812495
  NPD (past)
• Ummal B Mahuwala, PA-C

  • Physician Assistant
  • Dallas, TX
  • NPI 1124395025
  NPD (past)
• Esther Wangari Mungai, NP

  • Family Nurse Practitioner
  • Carrollton, TX
  • NPI 1003198284
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1275698532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750190378",
            "telephone_number": "972-492-9901",
            "fax_number": "972-492-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR STE 620",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106539",
            "telephone_number": "972-492-9901",
            "fax_number": "972-492-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DIABETES ENDOCRINOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "OBIALO",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-492-9901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0011LM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167630601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Precise Diagnostics LLC
• Precise Personalized Care Hospice LLC
• Precision ER Medical Services PLLC
• Precision Family Medicine, PA
• Premier Behavioral Health, PLLC
• Premier HHC LLC (Autumn Home Health)
• Premier Select Home Care LLC
• Prestige Imaging, LLC
• Paul William Preston, P.T.
• Prestonwood Anesthesia Associates PA

• Medical Specialty Clinic/Center in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.