Organization Active NPI

Bruce E. Douthit, MD, PA

  • Specialist
  • Frisco, TX
National Provider Identifier
1679798201
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G8826 Issued in TX
Legal business name
BRUCE E. DOUTHIT, MD, PA
Practice address
4461 Coit Rd Ste 101
Frisco, TX 75035-0522
Phone
(972) 335-8455
Fax
(972) 335-7560
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Lisa Brummett
Title
Clinic Coordinator
Phone
(972) 335-8455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G8826 TX Primary

Addresses

Primary practice location

4461 Coit Rd Ste 101
Frisco, TX 75035-0522

Mailing address

4461 Coit Rd
Ste 101
Frisco, TX 75035-0521
Phone (972) 335-8455

Other names 1

  • OASIS Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000583 TX Part B Supplier - Clinic/Group Practice 1254230170 Receives reassigned benefits from 2 practitioners
Practice locations: Frisco, TX

National Provider Directory

National Provider Directory

Locations

4461 Coit Rd
Ste 211
Frisco, TX 75035
Phone (214) 297-0008

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1679798201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 COIT RD",
            "address_2": "STE 101",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350521",
            "telephone_number": "972-335-8455",
            "fax_number": "972-335-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 COIT RD STE 101",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350522",
            "telephone_number": "972-335-8455",
            "fax_number": "972-335-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE E. DOUTHIT, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "BRUMMETT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CLINIC COORDINATOR",
        "authorized_official_telephone_number": "972-335-8455"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "G8826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OASIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.