Individual provider Active NPI

Brent W Walker, D.O.

  • Family Medicine Physician
  • Dallas, TX
National Provider Identifier
1629084793
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J2405 Issued in TX
Practice address
9101 N Central Expy
Suite 300
Dallas, TX 75231-5927
Phone
(214) 363-2305
Fax
(214) 363-2608
NPI assigned
Jul 31, 2006
Last updated
Jul 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J2405 TX Primary

Addresses

Primary practice location

9101 N Central Expy
Suite 300
Dallas, TX 75231-5927

Mailing address

9101 N Central Expy
Suite 300
Dallas, TX 75231-5927
Phone (214) 363-2305

Other identifiers 2

IdentifierTypeStateIssuer
123649902MedicaidTX
88X561OtherTXBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080417000644 TX Practitioner - Family Practice 3375457849 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince May 23, 2003 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Apr 1, 2008 Accepting new patients
Health Texas Provider Network-Family Practice of North Texas LLP Family Medicine PastSince Jun 24, 2005 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

9101 N Central Expy
Ste 300
Dallas, TX 75231
Phone (214) 363-2305

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1629084793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-363-2305",
            "fax_number": "214-363-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-363-2305",
            "fax_number": "214-363-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRENT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J2405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123649902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "88X561",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.