NPIMap

Organization Active NPI

Family Practice and Osteopathic Medicine Clinic

  • Family Medicine Physician
  • Plano, TX
National Provider Identifier
1346429032
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K4813 Issued in TX
Legal business name
FAMILY PRACTICE AND OSTEOPATHIC MEDICINE CLINIC
Practice address
1409 Shiloh Rd
Suite 150
Plano, TX 75074-4332
Phone
(972) 398-1665
Fax
(972) 398-1677
NPI assigned
Oct 30, 2007
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Dr. Farid Fred Taie, D.O.NPI 1427053313
Title
Dr.
Phone
(972) 398-1665

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K4813 TX Primary

Addresses

Primary practice location

1409 Shiloh Rd
Suite 150
Plano, TX 75074-4332

Mailing address

1409 Shiloh Rd
Suite 150
Plano, TX 75074-4332
Phone (972) 398-1665

Other identifiers 1

IdentifierTypeStateIssuer
0087MUOtherTXBLUE CROSS AND BLUE SHIEL

National Provider Directory

National Provider Directory

Locations

1409 Shiloh Rd
Ste 150
Plano, TX 75074
Phone (972) 398-1665

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": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1346429032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 SHILOH RD",
            "address_2": "SUITE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750744332",
            "telephone_number": "972-398-1665",
            "fax_number": "972-398-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 SHILOH RD",
            "address_2": "SUITE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750744332",
            "telephone_number": "972-398-1665",
            "fax_number": "972-398-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE AND OSTEOPATHIC MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "TAIE",
        "authorized_official_first_name": "FARID",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "972-398-1665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K4813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "0087MU",
            "state": "TX"
        }
    ],
    "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 Oct 30, 2007; 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.