Active NPI
David W Carlson MD PA
- Primary Care Clinic/Center
- Garland, TX
National Provider Identifier
1356768006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- HO233
- Legal business name
- DAVID W CARLSON MD PA
- Practice address
- 4402 Broadway Blvd
Suite 1
Garland, TX 75043-8263 - Phone
- (972) 240-1789
- NPI assigned
- Mar 19, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sylvia Carlson
- Title
- Business Manager
- Phone
- (972) 240-1789
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | HO233 | TX | Primary |
Addresses
Primary practice location
4402 Broadway Blvd
Suite 1
Garland, TX 75043-8263
Mailing address
4402 Broadway Blvd
Suite 1
Garland, TX 75043-8263
Phone (972) 240-1789
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700961406 | Other | TX | NPI |
| C14201 | Other | TX | UPIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0692129 | David W Carlson MD, PA | Provider-performed microscopy | Mar 30, 2027 |
National Provider Directory
National Provider DirectoryLocations
4402 Broadway Blvd
Ste 1
Garland, TX 75043
Phone (972) 240-1789
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Garland, TX
- NPI 1700961406
-
- Physician Assistant
- Garland, TX
- NPI 1043095706
-
- Physician Assistant
- Tomball, TX
- NPI 1346705845
-
- Medical Physician Assistant
- Garland, TX
- NPI 1871265611
-
- Family Medicine Physician
- Garland, TX
- NPI 1396207031
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1395187200000",
"number": "1356768006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4402 BROADWAY BLVD",
"address_2": "SUITE 1",
"city": "GARLAND",
"state": "TX",
"postal_code": "750438263",
"telephone_number": "972-240-1789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4402 BROADWAY BLVD",
"address_2": "SUITE 1",
"city": "GARLAND",
"state": "TX",
"postal_code": "750438263",
"telephone_number": "972-240-1789"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVID W CARLSON MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2014-03-19",
"last_updated": "2014-03-19",
"status": "A",
"authorized_official_last_name": "CARLSON",
"authorized_official_first_name": "SYLVIA",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "972-240-1789"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "TX",
"license": "HO233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1700961406",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "C14201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.