Organization Active NPI

Robert D. Menzies, MD, PLLC

  • Interventional Pain Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1639510936
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
M3643 Issued in TX
Legal business name
ROBERT D. MENZIES, MD, PLLC
Practice address
7148 Trail Lake Dr
Fort Worth, TX 76123-1969
Phone
(817) 294-0934
NPI assigned
Jul 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Authorized official

Name
Dr. Robert David Menzies, M.D.NPI 1225235179
Title
Owner
Phone
(817) 294-0934

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
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X M3643 TX Primary

Addresses

Primary practice location

7148 Trail Lake Dr
Fort Worth, TX 76123-1969

Mailing address

7148 Trail Lake Dr
Fort Worth, TX 76123-1969
Phone (817) 294-0934

Other identifiers 1

IdentifierTypeStateIssuer
196007201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131223001219 TX Part B Supplier - Clinic/Group Practice 7719114529 Receives reassigned benefits from 2 practitioners
Practice locations: Cleburne, TX; Fort Worth, TX; Granbury, TX

National Provider Directory

National Provider Directory

Locations

211 M and M Ranch Rd
Ste 101
Granbury, TX 76049

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1639510936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7148 TRAIL LAKE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231969",
            "telephone_number": "817-294-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7148 TRAIL LAKE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231969",
            "telephone_number": "817-294-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D. MENZIES, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "MENZIES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-294-0934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "M3643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196007201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "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 Jul 15, 2013; 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.