NPIMap

Organization Active NPI

Dallas Vamc

  • VA Clinic/Center
  • Tyler, TX
National Provider Identifier
1548929540
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
DALLAS VAMC
Practice address
428 Centennial Pkwy
Tyler, TX 75703-7166
Phone
(615) 355-3451
NPI assigned
Dec 17, 2021
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Erin Denise Potter
Title
Npi Team Member
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary

Addresses

Primary practice location

428 Centennial Pkwy
Tyler, TX 75703-7166

Mailing address

PO Box 94493
Cleveland, OH 44101-4493
Phone (615) 355-3451

Other names 1

  • TYLER VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Dallas Vamc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

428 Centennial Pkwy
Tyler, TX 75703
Phone (855) 375-6930

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1548929540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94493",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014493",
            "telephone_number": "615-355-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 CENTENNIAL PKWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037166",
            "telephone_number": "615-355-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TYLER VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.