John William Secor, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

F4504 Issued in TX

Practice address

8220 Walnut Hill LN Ste 710
Dallas, TX 75231-4427

Phone

(214) 368-6707

Fax

(214) 368-1804

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1568421014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 N STEMMONS FWY STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474228",
            "telephone_number": "214-689-5960",
            "fax_number": "469-713-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8220 WALNUT HILL LN STE 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314427",
            "telephone_number": "214-368-6707",
            "fax_number": "214-368-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECOR",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "F4504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125112602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "83Y777",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Evan Sebert, M.D.
• Beatrice Secheli
• Amy Jo Secker, MS, LPC-ASSOCIATE
• Second Chances Counseling and Wellness LLC
• Second Home Adult Care
• Lydia C. Secor, WHCNP
• Audrey Mae Secord, SLP-ASSISTANT
• Leslie H Secrest, M.D.
• Secure Haven Adult Day Care, Inc.
• Secure Patient Delivery of Texas, LLC

• Gastroenterology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.