Active NPI
Archana Srivastava MD PA
- Cardiovascular Disease Physician
- Dallas, TX
National Provider Identifier
1508304957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- ARCHANA SRIVASTAVA MD PA
- Practice address
- 4305 W. Wheatland Road
Suite 130
Dallas, TX 75237 - Phone
- (972) 296-0845
- Fax
- (972) 709-1790
- NPI assigned
- Feb 6, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Archana Srivastava, MD
- Title
- Director
- Phone
- (972) 296-0845
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
4305 W. Wheatland Road
Suite 130
Dallas, TX 75237
Mailing address
4305 W Wheatland Rd
Suite 130
Dallas, TX 75237-3311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170224000730 | TX | Part B Supplier - Clinic/Group Practice | 3678857398 |
Receives reassigned benefits from 1 practitioner Practice locations: Dallas, TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2135364 | Archana Srivastava, MD PA | Certificate of waiver | Aug 20, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Dallas, TX
- NPI 1881636231
Cardiovascular Disease, TX
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486339200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1591833600000",
"number": "1508304957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4305 W WHEATLAND RD",
"address_2": "SUITE 130",
"city": "DALLAS",
"state": "TX",
"postal_code": "752373311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4305 W. WHEATLAND ROAD",
"address_2": "SUITE 130",
"city": "DALLAS",
"state": "TX",
"postal_code": "75237",
"telephone_number": "972-296-0845",
"fax_number": "972-709-1790"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARCHANA SRIVASTAVA MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2017-02-06",
"last_updated": "2020-06-11",
"certification_date": "2020-06-11",
"status": "A",
"authorized_official_last_name": "SRIVASTAVA",
"authorized_official_first_name": "ARCHANA",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "972-296-0845",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.