NPIMap

Organization Active NPI

University of Texas Southwestern Medical Center at Dallas

Doing business as Multi Specialty Clinic in Tarrant County

  • Pediatrics Physician
  • Southlake, TX
National Provider Identifier
1275838732
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Doing business as
Multi Specialty Clinic in Tarrant County
Practice address
470 East State Hwy 114
Southlake, TX 76092-7625
Phone
(214) 645-0624
Fax
(214) 645-0624
NPI assigned
Jan 14, 2011
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Mark Meyer, M.D.
Title
Chief Financial Officer
Phone
(214) 633-4817

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU
Internal Medicine Physician 207R00000X NU
Hepatology Physician 207RI0008X NU
Nephrology Physician 207RN0300X NU
Ophthalmology Physician 207W00000X NU
Otolaryngology Physician 207Y00000X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU
Pediatrics Physician 208000000X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU
Psychiatry Physician 2084P0800X NU
Body Imaging Physician 2085B0100X NU
Diagnostic Radiology Physician 2085R0202X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU

Addresses

Primary practice location

470 East State Hwy 114
Southlake, TX 76092-7625

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (214) 645-0624

Other names 1

  • Multi Specialty Clinic in Tarrant County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000792 TX Part B Supplier - Clinic/Group Practice 0648188250 Receives reassigned benefits from 5,689 practitioners
46 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 43

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

View all 43

National Provider Directory

National Provider Directory
Tax ID family
University of Texas Southwestern Medical Center79 organizations share this tax ID, including this one
Part of
University of Texas Southwestern Medical Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 255

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 255

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1275838732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 EAST STATE HWY 114",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927625",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "enumeration_date": "2011-01-14",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "214-633-4817",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Multi Specialty Clinic in Tarrant County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Multi Specialty Clinic in Tarrant County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.