Organization Active NPI

Victor Nwiloh PA

  • Family Medicine Physician
  • Mansfield, TX
National Provider Identifier
1386068104
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VICTOR NWILOH PA
Practice address
1475 Heritage Pkwy
Suite 225
Mansfield, TX 76063-2735
Phone
(817) 453-7522
NPI assigned
Feb 13, 2014
Last updated
Jan 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Authorized official

Name
Victor M Nwiloh, MDNPI 1851338032
Title
Owner
Phone
(817) 453-7522

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 Physician 207Q00000X NU Primary

Addresses

Primary practice location

1475 Heritage Pkwy
Suite 225
Mansfield, TX 76063-2735

Mailing address

1475 Heritage Pkwy
225
Mansfield, TX 76063-2735
Phone (817) 453-7522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140630000476 TX Part B Supplier - Clinic/Group Practice 9335364629 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

2204 Joe Battle Blvd
Ste D204
El Paso, TX 79938
Phone (915) 300-2276

1475 Heritage Pkwy
Ste 225
Mansfield, TX 76063
Phone (817) 453-7522

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": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1386068104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 HERITAGE PKWY",
            "address_2": "225",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632735",
            "telephone_number": "817-453-7522",
            "fax_number": "866-665-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 HERITAGE PKWY",
            "address_2": "SUITE 225",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632735",
            "telephone_number": "817-453-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR NWILOH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-13",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "NWILOH",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-453-7522",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "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 Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.