NPIMap

Organization Active NPI

North Texas Vascular Center PA

  • Surgery Physician
  • Mesquite, TX
National Provider Identifier
1679981492
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
J1900 Issued in TX
Legal business name
NORTH TEXAS VASCULAR CENTER PA
Practice address
3865 Childress Ave
Suite C
Mesquite, TX 75150-2802
Phone
(972) 885-8346
Fax
(214) 466-1976
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Authorized official

Name
Miss Dawn Morgan
Title
Credentialing Coordinator
Phone
(941) 953-7451

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X J1900 TX Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X J1900 TX

Addresses

Primary practice location

3865 Childress Ave
Suite C
Mesquite, TX 75150-2802

Mailing address

3865 Childress Ave
Suite C
Mesquite, TX 75150-2802
Phone (972) 885-8346

National Provider Directory

National Provider Directory

Locations

3865 Childress Ave
Ste C
Mesquite, TX 75150
Phone (972) 885-8346

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1679981492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 CHILDRESS AVE",
            "address_2": "SUITE C",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502802",
            "telephone_number": "972-885-8346",
            "fax_number": "214-466-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 CHILDRESS AVE",
            "address_2": "SUITE C",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502802",
            "telephone_number": "972-885-8346",
            "fax_number": "214-466-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS VASCULAR CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "941-953-7451",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "J1900",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "J1900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.