Ken Steve Eades, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

E3903 Issued in TX

Practice address

815 Santa Fe Dr
100
Weatherford, TX 76086-6522

Phone

(817) 341-2861

Fax

(817) 341-3603

NPI assigned

Sep 20, 2007

Last updated

Sep 20, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Radiology Associates of North Texas PA

  • Diagnostic Radiology Physician
  • Fort Worth, TX
  • NPI 1710970975
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1437345642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 SANTA FE DR",
            "address_2": "100",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866522",
            "telephone_number": "817-341-2861",
            "fax_number": "817-341-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 SANTA FE DR",
            "address_2": "100",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866522",
            "telephone_number": "817-341-2861",
            "fax_number": "817-341-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADES",
        "first_name": "KEN",
        "middle_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E3903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Andrew Dunlap
• Mirisa Durch
• Dva Healthcare Renal Care, Inc. (Weatherford Dialysis)
• Rachel Katherine Dye, LPC
• E Medical Group of Texas No 1 LLC
• Eating Disorder Solutions of Texas LLC
• Katrina Eder
• Samantha L Edwards, LPC
• Terri Jo Edwards, AU.D.
• Mark Carroll Eidson, MD

• Specialist in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.