NPIMap

Organization Active NPI

Texas Physician Resources, LLP

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1639413289
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
TEXAS PHYSICIAN RESOURCES, LLP
Practice address
6451 Brentwood Stair Rd
Fort Worth, TX 76112-3200
Phone
(817) 451-4208
Fax
(817) 563-3699
NPI assigned
Nov 20, 2012
Last updated
Apr 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Sarah I Porter
Title
Director of Provider Enrollment
Phone
(817) 451-4208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

6451 Brentwood Stair Rd
Fort Worth, TX 76112-3200

Mailing address

PO Box 8549
Fort Worth, TX 76124-0549
Phone (817) 451-4208

Other identifiers 1

IdentifierTypeStateIssuer
1639413289MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Midlothian

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130214000159 TX Part B Supplier - Clinic/Group Practice 7012161375 Receives reassigned benefits from 287 practitioners
Practice locations: Dallas, TX; Southlake, TX; Midlothian, TX; Mansfield, TX

National Provider Directory

National Provider Directory

Locations

6451 Brentwood Stair Rd
Ft Worth, TX 76112
Phone 8174514208115

Practitioners & affiliated clinicians

Practitioners 288

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.

View all 288

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1639413289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8549",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761240549",
            "telephone_number": "817-451-4208",
            "fax_number": "817-563-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "817-451-4208",
            "fax_number": "817-563-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS PHYSICIAN RESOURCES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "817-451-4208"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639413289",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Midlothian",
            "affiliation": "N",
            "address_1": "6451 Brentwood Stair Rd",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761123200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.