NPIMap

Individual provider Active NPI

Erik William Maynard, M.D.

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1689712960
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6572 Issued in TX
Practice address
5204 S State Highway 360
Ste 400
Grand Prairie, TX 75052-0944
Phone
(972) 755-1785
Fax
(972) 602-4522
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J6572 TX Primary

Addresses

Primary practice location

5204 S State Highway 360
Ste 400
Grand Prairie, TX 75052-0944

Mailing address

5204 S State Highway 360
Ste 400
Grand Prairie, TX 75052-0944
Phone (972) 755-1785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603000740 TX Practitioner - Family Practice 0143202150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

1800 N Britain Rd
Parkland Health
Irving, TX 75061-2630
Phone (214) 266-3000

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

Hospital & facility affiliations

  • Parkland Health & Hospital System Hospital, Dallas, TX, CCN 450015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J6572TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District CurrentSince Feb 4, 2017 Accepting new patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District Family Medicine CurrentSince Feb 4, 2017 Accepting new patients
Clinical Practice Support Services CurrentSince Jan 1, 2016 Accepting new patients
Primamed Physicians PLLC PastSince Feb 9, 2025 Accepting new patients
Primamed Physicians PLLC PastSince Feb 9, 2025 Accepting new patients

Locations

5204 S State Highway 360
Ste 400
Grand Prairie, TX 75052
Phone (972) 755-1785

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

1811 Highway 287 N
Ste 150
Mansfield, TX 76063
Phone (817) 473-3979

Interoperability endpoints

  • Direct secure messaging: emaynard67769@direct.phhs.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1689712960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 S STATE HIGHWAY 360",
            "address_2": "STE 400",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520944",
            "telephone_number": "972-755-1785",
            "fax_number": "972-602-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 S STATE HIGHWAY 360",
            "address_2": "STE 400",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750520944",
            "telephone_number": "972-755-1785",
            "fax_number": "972-602-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "ERIK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.