NPIMap

Organization Active NPI

Van de Walle Family Dentistry

  • Dental Clinic/Center
  • San Marcos, TX
National Provider Identifier
1649536244
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
21761 Issued in TX
Legal business name
VAN DE WALLE FAMILY DENTISTRY
Practice address
111 Willows Springs Dr.
San Marcos, TX 78666-6076
Phone
(512) 878-2540
NPI assigned
Apr 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Thomas Van de WalleNPI 1801984448
Title
President
Phone
(512) 878-2540

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
Dental Clinic/Center 261QD0000X 21761 TX Primary

Addresses

Primary practice location

111 Willows Springs Dr.
San Marcos, TX 78666-6076

Mailing address

111 Willows Springs Dr
San Marcos, TX 78666-6076
Phone (512) 878-2540

National Provider Directory

National Provider Directory

Locations

111 Willow Springs Dr
San Marcos, TX 78666
Phone (512) 878-2540

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": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1649536244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WILLOWS SPRINGS DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666076",
            "telephone_number": "512-878-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WILLOWS SPRINGS DR.",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666076",
            "telephone_number": "512-878-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DE WALLE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "VAN DE WALLE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-878-2540"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "21761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.