NPIMap

Organization Active NPI

Burn and Reconstructive Centers of Texas

  • Surgery Physician
  • Plano, TX
National Provider Identifier
1316325905
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BURN AND RECONSTRUCTIVE CENTERS OF TEXAS
Practice address
3901 W 15TH St
Plano, TX 75075-7738
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
May 14, 2015
Last updated
Dec 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Shawn FaganNPI 1265448500
Title
Owner/MD
Phone
(706) 863-9595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

3901 W 15TH St
Plano, TX 75075-7738

Mailing address

PO Box 12187
Augusta, GA 30914-2187
Phone (706) 863-9595

Other practice location 1

1600 Coit Rd Ste 301
Plano, TX 75075-6172
Phone (706) 863-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151012000799 TX Part B Supplier - Clinic/Group Practice 4981913092 Receives reassigned benefits from 22 practitioners
Practice locations: San Antonio, TX; Plano, TX; Carrollton, TX

National Provider Directory

National Provider Directory

Locations

3675 J Dewey Gray Cir
Ste 300
Augusta, GA 30909
Phone (706) 869-0501

1850 Chadwick Dr
Ste 14247
Jackson, MS 39204

1600 Coit Rd
Ste 109
Plano, TX 75075
Phone (972) 396-4120

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1316325905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12187",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309142187",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 W 15TH ST",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757738",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Coit Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750756172",
            "country_code": "US",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BURN AND RECONSTRUCTIVE CENTERS OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "FAGAN",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "706-863-9595"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.