Active NPI
Tim Alan Farrell, DDS
- Dentist
- Houston, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15615
- Practice address
- 1445 N Loop West
Suite 1000
Houston, TX 77008 - Phone
- (713) 861-3231
- Fax
- (713) 426-1720
- NPI assigned
- Apr 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15615 | TX | Primary |
Addresses
Primary practice location
1445 N Loop West
Suite 1000
Houston, TX 77008
Mailing address
1216 Harbortown Dr
Sugar Land, TX 77478
Phone (281) 491-3184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15615 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Valley Health Corporation | Current | Accepting new patients | |
| Northeast Valley Health Corporation | Current | Accepting new patients | |
| Robert C Gohlke DDS Inc | Dentist | Past | Accepting new patients |
Locations
7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656
1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388
1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086
Interoperability endpoints
- tim.farrell.p1@direct.nevhc.nextgenshare.com
Organizations & group practices 3
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.
-
dba Van Nuys Adult Health Center
- Federally Qualified Health Center (FQHC)
- Van Nuys, CA
- NPI 1629079009
-
dba San Fernando Health Center
- Federally Qualified Health Center (FQHC)
- San Fernando, CA
- NPI 1235130600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568688554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 HARBORTOWN DR",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "77478",
"telephone_number": "281-491-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 N LOOP WEST",
"address_2": "SUITE 1000",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77008",
"telephone_number": "713-861-3231",
"fax_number": "713-426-1720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "TIM",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "15615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.