Organization Active NPI

Txiom, LLC

  • Specialist
  • Fort Worth, TX
National Provider Identifier
1689075095
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
F0555 Issued in TX
Legal business name
TXIOM, LLC
Practice address
500 Throckmorton Street
Unit 3012
Fort Worth, TX 76102
Phone
(817) 908-8124
NPI assigned
Sep 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Authorized official

Name
Dr. Augusto Cezar Lastimosa, M.D.
Title
President
Phone
(817) 908-8124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X F0555 TX Primary

Addresses

Primary practice location

500 Throckmorton Street
Unit 3012
Fort Worth, TX 76102

Mailing address

500 Throckmorton Street
Unit 3012
Fort Worth, TX 76102
Phone (817) 908-8124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171107001284 TX Part B Supplier - Clinic/Group Practice 3678839735 Receives reassigned benefits from 3 practitioners
Practice locations: Frisco, TX; Fort Worth, TX; Euless, TX; Arlington, TX; Denton, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1689075095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 THROCKMORTON STREET",
            "address_2": "UNIT 3012",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-908-8124",
            "fax_number": "817-885-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 THROCKMORTON STREET",
            "address_2": "UNIT 3012",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76102",
            "telephone_number": "817-908-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TXIOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "LASTIMOSA",
        "authorized_official_first_name": "AUGUSTO",
        "authorized_official_middle_name": "CEZAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-908-8124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F0555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.