Organization Active NPI

Texas Health Care, P.L.L.C.

  • Vascular Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1487962916
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
TEXAS HEALTH CARE, P.L.L.C.
Practice address
1250 8TH Ave.,
Suite 240
Fort Worth, TX 76104-4124
Phone
(817) 927-0456
Fax
(817) 927-4323
NPI assigned
Sep 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Larry D. Tatum, M.D.
Title
C.E.O.
Phone
(817) 740-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1250 8TH Ave.,
Suite 240
Fort Worth, TX 76104-4124

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other identifiers 1

IdentifierTypeStateIssuer
155109501MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Texas Health Care PLLC24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

1250 8th Ave
Ste 240
Fort Worth, TX 76104

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1487962916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-378-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 8TH AVE.,",
            "address_2": "SUITE 240",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044124",
            "telephone_number": "817-927-0456",
            "fax_number": "817-927-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HEALTH CARE, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "TATUM",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "817-740-8400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155109501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.