Individual provider Active NPI

Tammy L. Broxson, MD

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1629027792
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L4488 Issued in TX
Practice address
5470 W. Lovers Lane
Suite 330
Dallas, TX 75209
Phone
(214) 956-7337
Fax
(469) 364-8724
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L4488 TX Primary

Addresses

Primary practice location

5470 W. Lovers Lane
Suite 330
Dallas, TX 75209

Mailing address

5470 W. Lovers Lane
Suite 330
Dallas, TX 75209
Phone (214) 956-7337

Other identifiers 4

IdentifierTypeStateIssuer
L4488OtherTXMEDICAL LICENSE
05-0622563OtherTXTAX NUMBER
7313193OtherTXAETNA PIN NUMBER
0020KWOtherTXBCBS PROVIDER ID

Other names 1

  • Dr. Tammy Zuber West Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L4488TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inwood Village Pediatrics Pediatrics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1629027792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5470 W. LOVERS LANE",
            "address_2": "SUITE 330",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75209",
            "telephone_number": "214-956-7337",
            "fax_number": "469-364-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 W. LOVERS LANE",
            "address_2": "SUITE 330",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75209",
            "telephone_number": "214-956-7337",
            "fax_number": "469-364-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROXSON",
        "first_name": "TAMMY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L4488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "L4488",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX NUMBER",
            "identifier": "05-0622563",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN NUMBER",
            "identifier": "7313193",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "0020KW",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "WEST",
            "middle_name": "ZUBER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 10, 2016; 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.