NPIMap

Organization Active NPI

Superior Healthcare Services LLC

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1689262941
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUPERIOR HEALTHCARE SERVICES LLC
Practice address
512 W Bonds Ranch Rd Ste 150
Fort Worth, TX 76131-3915
Phone
(817) 488-6369
NPI assigned
Jan 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2026

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

Authorized official

Name
Mr. Victor Manuel Granados
Title
President
Phone
(817) 501-2214

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0005X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

512 W Bonds Ranch Rd Ste 150
Fort Worth, TX 76131-3915

Mailing address

512 W Bonds Ranch Rd Ste 150
Fort Worth, TX 76131-3915
Phone (817) 488-6369

Other identifiers 2

IdentifierTypeStateIssuer
AP143560OtherTXNURSE PRACTITIONER LICENSE NUMBER
1790327161OtherNPI NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607003268 TX Part B Supplier - Clinic/Group Practice 8527468982 Receives reassigned benefits from 19 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

3348 Peden Rd
Fort Worth, TX 76179
Phone (214) 334-6508

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778889600000",
    "number": "1689262941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 W BONDS RANCH RD STE 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761313915",
            "telephone_number": "817-488-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W BONDS RANCH RD STE 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761313915",
            "telephone_number": "817-488-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-501-2214",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE NUMBER",
            "identifier": "AP143560",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1790327161",
            "state": null
        }
    ],
    "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 May 16, 2026; 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.