Fort Worth Vascular Specialists Corp

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

FORT WORTH VASCULAR SPECIALISTS CORP

Practice address

5750 Stratum Dr
Fort Worth, TX 76137-2757

Phone

(817) 989-2580

Fax

(817) 989-6555

NPI assigned

Mar 10, 2020

Organization subpart

No

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

Authorized official

Name

Yury Gampel

Title

Manager

Phone

(818) 880-8605

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1396370334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26500 AGOURA RD STE 102-587",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021952",
            "telephone_number": "818-880-8605",
            "fax_number": "818-579-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 STRATUM DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761372757",
            "telephone_number": "817-989-2580",
            "fax_number": "817-989-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH VASCULAR SPECIALISTS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "GAMPEL",
        "authorized_official_first_name": "YURY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-880-8605"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471V0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular-Interventional Technology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Worth Surgicare Partners LTD
• Fort Worth Surgicare Partners, LTD
• Fort Worth Surgicare Partners, LTD.
• Fort Worth Therapy & Wellness, PLLC
• Fort Worth Vascular and Surgical Associates, PA
• Fort Worth VI Enterprises, LLC
• Fort Worth Vision
• Fort Worth Woman'S Clinic
• Fort Worth/Dallas Birthing Project
• Juston Forte

• Vascular & Interventional Radiology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Vascular & Interventional Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.