NPIMap

Organization Active NPI

Golden Hawk Medical

  • Case Management Agency
  • Garland, TX
National Provider Identifier
1487977849
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
GOLDEN HAWK MEDICAL
Practice address
4402 Broadway Blvd
2
Garland, TX 75043-8263
Phone
(214) 641-8494
NPI assigned
Mar 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Authorized official

Name
Ms. Betty JetawoNPI 1568690576
Title
Administrator
Phone
(214) 641-8494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

4402 Broadway Blvd
2
Garland, TX 75043-8263

Mailing address

4402 Broadway Blvd
2
Garland, TX 75043-8263

National Provider Directory

National Provider Directory

Locations

4402 Broadway Blvd
Ste 2
Garland, TX 75043
Phone (214) 641-8494

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": "1268352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1487977849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 BROADWAY BLVD",
            "address_2": "2",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750438263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 BROADWAY BLVD",
            "address_2": "2",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750438263",
            "telephone_number": "214-641-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN HAWK MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "JETAWO",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-641-8494",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.