Organization Active NPI

Southwest Arlington Medical Clinic, P.a.

  • Family Medicine Physician
  • Pantego, TX
National Provider Identifier
1457580805
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F4157 Issued in TX
Legal business name
SOUTHWEST ARLINGTON MEDICAL CLINIC, P.A.
Practice address
2313 W Arkansas LN Ste 100
Pantego, TX 76013-6034
Phone
(817) 261-3302
Fax
(817) 277-0674
NPI assigned
Jul 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Robert C Kent, D.O.
Title
Doctor
Phone
(817) 261-3302

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X F4157 TX Primary

Addresses

Primary practice location

2313 W Arkansas LN Ste 100
Pantego, TX 76013-6034

Mailing address

2313 W Arkansas LN Ste 100
Pantego, TX 76013-6034
Phone (817) 261-3302

Other identifiers 1

IdentifierTypeStateIssuer
0097LXOtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

2313 W Arkansas Ln
Ste 100
Pantego, TX 76013
Phone (817) 261-3302

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1457580805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 W ARKANSAS LN STE 100",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760136034",
            "telephone_number": "817-261-3302",
            "fax_number": "817-277-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 W ARKANSAS LN STE 100",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760136034",
            "telephone_number": "817-261-3302",
            "fax_number": "817-277-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ARLINGTON MEDICAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "817-261-3302",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F4157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0097LX",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pantego, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.