Active NPI
Dennis L Landes, LAT
- Athletic Trainer
- Fort Worth, TX
National Provider Identifier
1376750323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT1023
- Practice address
- 4210 Boat Club Rd
Fort Worth, TX 76135-2606 - Phone
- (817) 306-4200
- Fax
- (817) 238-8053
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT1023 | TX | Primary |
Addresses
Primary practice location
4210 Boat Club Rd
Fort Worth, TX 76135-2606
Mailing address
1941 Colorado Blvd
Apt a
Denton, TX 76205-7537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT1023 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376750323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1941 COLORADO BLVD",
"address_2": "APT A",
"city": "DENTON",
"state": "TX",
"postal_code": "762057537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 BOAT CLUB RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761352606",
"telephone_number": "817-306-4200",
"fax_number": "817-238-8053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDES",
"first_name": "DENNIS",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT1023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.