Organization Active NPI

Renaissance Clinical Research & Hypertension Clinic of Texas PLLC

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1578689675
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E0896 Issued in TX
Legal business name
RENAISSANCE CLINICAL RESEARCH & HYPERTENSION CLINIC OF TEXAS PLLC
Practice address
5959 Harry Hines Blvd
Suite 820
Dallas, TX 75235-6234
Phone
(214) 638-1773
NPI assigned
Mar 21, 2007
Last updated
Aug 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Authorized official

Name
Dr. Waymon Drummond, M.D.NPI 1659310597
Title
Director
Phone
(214) 638-1773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X E0896 TX Primary

Addresses

Primary practice location

5959 Harry Hines Blvd
Suite 820
Dallas, TX 75235-6234

Mailing address

5959 Harry Hines Blvd
Suite 820
Dallas, TX 75235-6234
Phone (214) 638-1773

Other identifiers 1

IdentifierTypeStateIssuer
083741102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051011001214 TX Part B Supplier - Clinic/Group Practice 9032134713 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Clinical Research2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5959 Harry Hines Blvd
Ste 820
Dallas, TX 75235
Phone (214) 638-1773

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345680000000",
    "number": "1578689675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 HARRY HINES BLVD",
            "address_2": "SUITE 820",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752356234",
            "telephone_number": "214-638-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 HARRY HINES BLVD",
            "address_2": "SUITE 820",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752356234",
            "telephone_number": "214-638-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE CLINICAL RESEARCH & HYPERTENSION CLINIC OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-08-23",
        "status": "A",
        "authorized_official_last_name": "DRUMMOND",
        "authorized_official_first_name": "WAYMON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-638-1773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E0896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083741102",
            "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 Aug 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.