NPIMap

Organization Active NPI

W B Carrell Memorial Clinic

  • Orthopaedic Surgery Physician
  • Dallas, TX
National Provider Identifier
1679501746
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
W B CARRELL MEMORIAL CLINIC
Practice address
9301 N Central Expy
Suite 400
Dallas, TX 75231-0806
Phone
(214) 220-2468
Fax
(214) 953-1210
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Authorized official

Name
Tom Blair
Title
Chief Exectutive Office
Phone
(214) 220-2468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

9301 N Central Expy
Suite 400
Dallas, TX 75231-0806

Mailing address

9301 N Central Expy
Suite 400
Dallas, TX 75231-0806
Phone (214) 220-2468

Other identifiers 4

IdentifierTypeStateIssuer
00EB96OtherTXBCBS OF TEXAS
094807702MedicaidTX
178801100OtherTXDEPT OF LABOR
094807703MedicaidTX

National Provider Directory

National Provider Directory

Locations

9301 N Central Expy
Ste 220
Dallas, TX 75231
Phone (210) 220-2468

Practitioners & affiliated clinicians

Practitioners 9

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1679501746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 N CENTRAL EXPY",
            "address_2": "SUITE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310806",
            "telephone_number": "214-220-2468",
            "fax_number": "214-953-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 N CENTRAL EXPY",
            "address_2": "SUITE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310806",
            "telephone_number": "214-220-2468",
            "fax_number": "214-953-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W B CARRELL MEMORIAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CHIEF EXECTUTIVE OFFICE",
        "authorized_official_telephone_number": "214-220-2468"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00EB96",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094807702",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "178801100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094807703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.