NPIMap

Organization Active NPI

Otolaryngology Specialists of North Texas PA

  • Specialist
  • Plano, TX
National Provider Identifier
1386079267
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
K3577 H8358 Issued in TX
Legal business name
OTOLARYNGOLOGY SPECIALISTS OF NORTH TEXAS PA
Practice address
6300 W Parker Rd
Suite 326
Plano, TX 75093-8100
Phone
(972) 378-0633
Fax
(972) 278-0656
NPI assigned
Sep 10, 2013
Last updated
Sep 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Authorized official

Name
Dr. Bradford A Gamble, MDNPI 1629021498
Title
Partner
Phone
(972) 378-0633

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
Specialist 174400000X K3577 H8358 TX Primary

Addresses

Primary practice location

6300 W Parker Rd
Suite 326
Plano, TX 75093-8100

Mailing address

6300 W Parker Rd
Suite 326
Plano, TX 75093-8100
Phone (972) 378-0633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131202000727 TX Part B Supplier - Clinic/Group Practice 4981830627 Receives reassigned benefits from 10 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

6300 W Parker Rd
Ste 326
Plano, TX 75093
Phone (972) 378-0633

6300 W Parker Rd
Ste G24
Plano, TX 75093
Phone (972) 378-0633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDGDCA

Practitioners & affiliated clinicians

Practitioners 10

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": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1386079267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD",
            "address_2": "SUITE 326",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938100",
            "telephone_number": "972-378-0633",
            "fax_number": "972-278-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD",
            "address_2": "SUITE 326",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938100",
            "telephone_number": "972-378-0633",
            "fax_number": "972-278-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTOLARYNGOLOGY SPECIALISTS OF NORTH TEXAS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "972-378-0633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K3577 H8358",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 10, 2013; 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.