NPIMap

Organization Active NPI

Texas Physicians Group

  • Cardiovascular Disease Physician
  • Lubbock, TX
National Provider Identifier
1497014369
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
TEXAS PHYSICIANS GROUP
Practice address
4802 N Loop 289
Lubbock, TX 79416-3025
Phone
(806) 788-0040
NPI assigned
May 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X K5418 TX
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

4802 N Loop 289
Lubbock, TX 79416-3025

Mailing address

4802 N Loop 289
Lubbock, TX 79416-3025
Phone (806) 788-0040

Other practice location 1

4642 N Loop 289 Ste 211
Lubbock, TX 79416-2425
Phone (806) 722-2161

Other practice location 2

6102 82nd St Ste 14
Lubbock, TX 79424-0840
Phone (806) 712-0446

Other practice location 3

4802 N Loop 289
Lubbock, TX 79416-3025
Phone (806) 788-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120727000066 TX Part B Supplier - Clinic/Group Practice 0042476582 Receives reassigned benefits from 32 practitioners
Practice locations: Brownfield, TX; Lubbock, TX; Muleshoe, TX; Snyder, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2134253Texas Physicians Group-Iola Clinic6102 82ND Unit 14, Lubbock, TX 79424Certificate of waiverJul 27, 2027

National Provider Directory

National Provider Directory

Locations

201 Franklin Rd
Ste 100
Brentwood, TN 37027

6633 E Highway 290
Ste 101
Austin, TX 78723
Phone (512) 288-0533

10208 Quaker Ave
#B
Lubbock, TX 79424
Phone (806) 712-0002

10208 Quaker Ave
Ste 200B
Lubbock, TX 79424
Phone (806) 712-9007

10208 Quaker Ave
Lubbock, TX 79424
Phone (806) 795-4500

4802 N Loop 289
Lubbock, TX 79416
Phone (806) 788-0004

6102 82nd St
Ste B
Lubbock, TX 79424

701 S 1st St
Muleshoe, TX 79347
Phone (806) 272-4524

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24018/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1497014369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-788-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163025",
            "telephone_number": "806-788-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4642 N Loop 289 Ste 211",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794162425",
            "country_code": "US",
            "telephone_number": "806-722-2161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6102 82nd St Ste 14",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794240840",
            "country_code": "US",
            "telephone_number": "806-712-0446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4802 N Loop 289",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794163025",
            "country_code": "US",
            "telephone_number": "806-788-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2021-07-23",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5900"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K5418",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.