Villa Creek Medical Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D6910 Issued in TX

Legal business name

VILLA CREEK MEDICAL INC

Practice address

12300 Ford Rd
Suite B-324
Farmers Branch, TX 75234-7248

Phone

(972) 243-3650

Fax

(972) 243-3676

NPI assigned

Feb 9, 2015

Organization subpart

No

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

Authorized official

Name

Ricardo S Romero

Title

Owner

Phone

(972) 243-3650

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1417348780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 FORD RD",
            "address_2": "SUITE B-324",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752347248",
            "telephone_number": "972-243-3650",
            "fax_number": "972-243-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 FORD RD",
            "address_2": "SUITE B-324",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752347248",
            "telephone_number": "972-243-3650",
            "fax_number": "972-243-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA CREEK MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-243-3650"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D6910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.