NPIMap

Organization Active NPI

Texas Digestive Disease Consultants, PLLC

  • Clinical Medical Laboratory
  • Bedford, TX
National Provider Identifier
1275739815
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
45D1067054 Issued in TX
Legal business name
TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC
Practice address
1800 Plaza Dr
Bedford, TX 76021-6013
Phone
(817) 310-4490
Fax
(817) 310-4491
NPI assigned
Jun 21, 2007
Last updated
Apr 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Kristina Kay Lowery
Title
Credentialing Manager
Phone
(317) 919-9025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 45D1067054 TX Primary

Addresses

Primary practice location

1800 Plaza Dr
Bedford, TX 76021-6013

Mailing address

950 E State Highway 114 Ste 200
Southlake, TX 76092-5261
Phone (214) 424-2200

Other practice location 1

505 S Nolen Dr
Ste B
Southlake, TX 76092-9167
Phone (817) 310-4490

Other identifiers 1

IdentifierTypeStateIssuer
197339801MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address giasouthcentral@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040505001844 TX Part B Supplier - Clinic/Group Practice 3375531379 Receives reassigned benefits from 703 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20071004000877 TX Part B Supplier - Independent Clinical Laboratory 3375531379 Practice locations: Bedford, TX

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
45D0943109Texas Digestive Disease Consultants PA505 S Nolen Drive, Suite a, Southlake, TX 76092Certificate of waiverMar 22, 2028
45D1067054Texas Digestive Disease Consultants1800 Plaza Dr, Bedford, TX 76021AccreditationOct 8, 2027

National Provider Directory

National Provider Directory

Locations

3417 Gaston Ave
Ste 790
Dallas, TX 75246
Phone (214) 545-3990

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1275739815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 E STATE HIGHWAY 114 STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925261",
            "telephone_number": "214-424-2200",
            "fax_number": "214-231-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PLAZA DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760216013",
            "telephone_number": "817-310-4490",
            "fax_number": "817-310-4491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Nolen Dr",
            "address_2": "STE B",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760929167",
            "country_code": "US",
            "telephone_number": "817-310-4490",
            "fax_number": "817-310-4491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS DIGESTIVE DISEASE CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "LOWERY",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "317-919-9025"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D1067054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197339801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "giasouthcentral@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Plaza Dr",
            "city": "Bedford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760216013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.