Individual provider Active NPI

Timonet B Abuloc, NP

  • Family Nurse Practitioner
  • Garland, TX
National Provider Identifier
1548427156
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
513568 Issued in TX
Practice address
2605 Chesapeake Dr
Garland, TX 75043-0901
Phone
(214) 714-0117
Fax
(469) 298-3335
NPI assigned
May 21, 2008
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 513568 TX Primary

Addresses

Primary practice location

2605 Chesapeake Dr
Garland, TX 75043-0901

Mailing address

2605 Chesapeake Dr
Garland, TX 75043-0901
Phone (214) 714-0117

Other identifiers 1

IdentifierTypeStateIssuer
1934309MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000311 TX Practitioner - Nurse Practitioner 4789755190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2605 Chesapeake Dr
Garland, TX 75043-0901
Phone (214) 714-0117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
513568TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vijaya Nama M.D PA CurrentSince Sep 1, 2015 Accepting new patients
Prompt Care Internal Medicine PA Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients

Locations

4800 N Galloway Ave
Ste 300
Mesquite, TX 75150
Phone (972) 587-9846

5115 N Galloway Ave
Ste 304
Mesquite, TX 75150
Phone (972) 613-2127

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14525/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1548427156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 CHESAPEAKE DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750430901",
            "telephone_number": "214-714-0117",
            "fax_number": "469-298-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 CHESAPEAKE DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750430901",
            "telephone_number": "214-714-0117",
            "fax_number": "469-298-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABULOC",
        "first_name": "TIMONET",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "513568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1934309",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.