Organization Active NPI

Fairfield Family Physicians, PA

  • Family Medicine Physician
  • Cypress, TX
National Provider Identifier
1366549347
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAIRFIELD FAMILY PHYSICIANS, PA
Practice address
15201 Mason Rd
#1200
Cypress, TX 77433-5954
Phone
(281) 373-0162
Fax
(281) 373-0765
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Dr. Trung D Dinh, M.D.NPI 1083710271
Title
President
Phone
(281) 373-0162

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 Primary

Addresses

Primary practice location

15201 Mason Rd
#1200
Cypress, TX 77433-5954

Mailing address

15201 Mason Rd
#1200
Cypress, TX 77433-5954
Phone (281) 373-0162

Other identifiers 2

IdentifierTypeStateIssuer
0003LEOtherBCBS
169777301MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040729001630 TX Part B Supplier - Clinic/Group Practice 9739159328 Receives reassigned benefits from 2 practitioners
Practice locations: Cypress, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0994322Fairfield Family Physicians PA15201 Mason Rd # 1200, Cypress, TX 77433Certificate of waiverDec 10, 2027

National Provider Directory

National Provider Directory

Locations

15201 Mason Rd
Ste 1200
Cypress, TX 77433
Phone (281) 373-0162

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1366549347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15201 MASON RD",
            "address_2": "#1200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335954",
            "telephone_number": "281-373-0162",
            "fax_number": "281-373-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15201 MASON RD",
            "address_2": "#1200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774335954",
            "telephone_number": "281-373-0162",
            "fax_number": "281-373-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD FAMILY PHYSICIANS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "DINH",
        "authorized_official_first_name": "TRUNG",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-373-0162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0003LE",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169777301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.

Verify at the official NPI Registry.