NPIMap

Organization Active NPI

Phoenix Houses of Texas, Inc

  • Multi-Specialty Clinic/Center
  • Dallas, TX
National Provider Identifier
1508992249
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
865 Issued in TX
Legal business name
PHOENIX HOUSES OF TEXAS, INC
Practice address
2345 Reagan St
Dallas, TX 75219-3225
Phone
(214) 999-1044
Fax
(214) 526-3285
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Authorized official

Name
Mr. Bart R Loewen
Title
President & Ceo
Phone
(214) 920-1628

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 865 TX Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

2345 Reagan St
Dallas, TX 75219-3225

Mailing address

1910 Pacific Ave Ste 10500
Dallas, TX 75201-4591
Phone (214) 920-1628

Other practice location 1

400 W Live Oak St
Austin, TX 78704-5119
Phone (512) 440-0613

Other practice location 2

2351 W Northwest Hwy Ste 3265
Dallas, TX 75220-8405
Phone (214) 920-1628 ext. 8914

Other identifiers 6

IdentifierTypeStateIssuer
170251601MedicaidTX
865-865MOtherSTATE OF TEXAS
865-865POtherSTATE OF TEXAS
065459201MedicaidTX
319371601MedicaidTX
335999401MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Houses of Texas Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2345 Reagan St
Dallas, TX 75219
Phone (214) 999-1044

Practitioners & affiliated clinicians

Practitioners 7

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671494400000",
    "number": "1508992249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PACIFIC AVE STE 10500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014591",
            "telephone_number": "214-920-1628",
            "fax_number": "214-351-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 REAGAN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193225",
            "telephone_number": "214-999-1044",
            "fax_number": "214-526-3285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W Live Oak St",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787045119",
            "country_code": "US",
            "telephone_number": "512-440-0613",
            "fax_number": "512-440-0235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2351 W Northwest Hwy Ste 3265",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752208405",
            "country_code": "US",
            "telephone_number": "214-920-1628 x8914",
            "fax_number": "214-351-0967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHOENIX HOUSES OF TEXAS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A",
        "authorized_official_last_name": "LOEWEN",
        "authorized_official_first_name": "BART",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "214-920-1628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TX",
            "license": "865",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170251601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "865-865M",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "865-865P",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065459201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319371601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335999401",
            "state": "TX"
        }
    ],
    "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 Dec 20, 2022; 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.