NPIMap

Organization Active NPI

Dallas Vamc

  • VA Clinic/Center
  • Tyler, TX
National Provider Identifier
1629459730
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
DALLAS VAMC
Practice address
7916 S Broadway Ave Ste 100
Tyler, TX 75703-5275
Phone
(615) 355-3451
NPI assigned
Jun 15, 2015
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Erin Potter
Title
Npi Team Member
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X NU Primary

Addresses

Primary practice location

7916 S Broadway Ave Ste 100
Tyler, TX 75703-5275

Mailing address

PO Box 94493
Cleveland, OH 44101
Phone (615) 355-3451

Other names 1

  • TYLER 1 VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Dallas Vamc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

7916 S Broadway Ave
Ste 100
Tyler, TX 75703
Phone (903) 266-5900

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1629459730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94493",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44101",
            "telephone_number": "615-355-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7916 S BROADWAY AVE STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035275",
            "telephone_number": "615-355-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TYLER 1 VA CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "TYLER 1 VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.