NPIMap

Organization Active NPI

Texas Pain Relief Group PLLC

Doing business as Texas Primary Care Group

  • Family Nurse Practitioner
  • Hurst, TX
National Provider Identifier
1396128328
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TEXAS PAIN RELIEF GROUP PLLC
Doing business as
Texas Primary Care Group
Practice address
1717 Precinct Line Rd
Suite 200
Hurst, TX 76054-3169
Phone
(813) 549-2134
Fax
(813) 870-1383
NPI assigned
Jul 8, 2015
Last updated
Jan 20, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
TEXAS PAIN RELIEF GROUP PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Authorized official

Name
David Wood
Title
Manager
Phone
(813) 549-2134

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

1717 Precinct Line Rd
Suite 200
Hurst, TX 76054-3169

Mailing address

4730 N Habana Ave
Suite 204
Tampa, FL 33614-7163
Phone (813) 549-2134

Other names 1

  • Texas Primary Care Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140331000940 TX Part B Supplier - Clinic/Group Practice 2668603952 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dallas, TX; Duncanville, TX; Fort Worth, TX; Frisco, TX; Hurst, TX; McKinney, TX; Plano, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Texas Pain Relief Group PLL

Locations

1717 Precinct Line Rd
Ste 200
Hurst, TX 76054
Phone (817) 369-3990

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453248000000",
    "number": "1396128328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 N HABANA AVE",
            "address_2": "SUITE 204",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147163",
            "telephone_number": "813-549-2134",
            "fax_number": "813-870-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 PRECINCT LINE RD",
            "address_2": "SUITE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543169",
            "telephone_number": "813-549-2134",
            "fax_number": "813-870-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS PAIN RELIEF GROUP PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEXAS PAIN RELIEF GROUP PLLC",
        "enumeration_date": "2015-07-08",
        "last_updated": "2016-01-20",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-549-2134"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Primary Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hurst, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.