NPIMap

Organization Active NPI

Strategic Medical Group TX PLLC

  • Primary Care Clinic/Center
  • Mansfield, TX
National Provider Identifier
1336971399
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
STRATEGIC MEDICAL GROUP TX PLLC
Practice address
1720 E Broad St
Mansfield, TX 76063-3400
Phone
(817) 453-5912
NPI assigned
Aug 19, 2024
Last updated
Aug 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Omar F SelodNPI 1962471607
Title
Owner
Phone
(817) 336-7188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1720 E Broad St
Mansfield, TX 76063-3400

Mailing address

4400 Oak Park LN
Fort Worth, TX 76109-9534
Phone (817) 985-7772

National Provider Directory

National Provider Directory
Tax ID family
Strategic Med GRP TX PLLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1336971399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 OAK PARK LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761099534",
            "telephone_number": "817-985-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E BROAD ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633400",
            "telephone_number": "817-453-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRATEGIC MEDICAL GROUP TX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "SELOD",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-336-7188"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.