Patrick T. Roughneen, M.D,, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

J1480 Issued in TX

Legal business name

PATRICK T. ROUGHNEEN, M.D,, P.A.

Practice address

1600 W College St
Suite 555
Grapevine, TX 76051-3589

Phone

(817) 552-1900

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Kimchi Thi Nguyen

Title

Office Manager

Phone

(817) 552-1900

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1285848804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE 555",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513589",
            "telephone_number": "817-552-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COLLEGE ST",
            "address_2": "SUITE 555",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513589",
            "telephone_number": "817-552-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK T. ROUGHNEEN, M.D,, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIMCHI",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-552-1900"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "J1480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00323790",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171001401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gerald Gene Payne Jr., MD

• Specialist in Grapevine, TX
• Providers in Grapevine, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.