NPIMap

Individual provider Active NPI

Charles Dan Demarque, M.D.

  • Emergency Medicine Physician
  • Irving, TX
National Provider Identifier
1659315828
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD27491 Issued in TN
Practice address
2940 N O Connor Rd Ste 129
Irving, TX 75062-8808
Phone
(817) 308-8477
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X J1969 TX
Emergency Medicine Physician 207P00000X MD27491 TN Primary

Addresses

Primary practice location

2940 N O Connor Rd Ste 129
Irving, TX 75062-8808

Mailing address

2940 N O Connor Rd Ste 129
Irving, TX 75062-8808
Phone (817) 308-8477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD27491TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Rose Medical Foundation Inc. Emergency Medicine Past Accepting new patients
Stonewall Memorial Hospital Past Accepting new patients
Cedar Bluff Emergency Physicians Emergency Medicine Past Accepting new patients
Old Settlers Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Stonewall Memorial Hospital Emergency Medicine Past Accepting new patients
NP Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Glen Rose Medical Foundation Emergency Medicine Past Accepting new patients
Hendrick Southwestern Health Development Corporation Past Accepting new patients
Bachman Lake Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Gonzales Healthcare Systems Past Accepting new patients
Austin Premier Emergency Physicians Emergency Medicine Past Accepting new patients
KTX Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1659315828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 N O CONNOR RD STE 129",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750628808",
            "telephone_number": "817-308-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N O CONNOR RD STE 129",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750628808",
            "telephone_number": "817-308-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARQUE",
        "first_name": "CHARLES",
        "middle_name": "DAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "J1969",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD27491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.