Individual provider Active NPI

Ramon Miguel Fajardo

  • Physical Therapist
  • Dallas, TX
National Provider Identifier
1700573441
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
6011 Harry Hines Blvd
Dallas, TX 75235-5386
Phone
(214) 648-6510
Fax
(214) 648-6285
NPI assigned
Apr 21, 2023
Last updated
Apr 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

6011 Harry Hines Blvd
Dallas, TX 75235-5386

Mailing address

5323 Harry Hines Blvd
Dallas, TX 75390-8876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124001701 TX Practitioner - Physical Therapist in Private Practice 3375996598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas Physical Therapist CurrentSince Dec 13, 2023 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 13, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

6011 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 648-6510

6011 Harry Hines Blvd
Ste V3
Dallas, TX 75235
Phone (214) 648-6562

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1700573441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753908876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355386",
            "telephone_number": "214-648-6510",
            "fax_number": "214-648-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "RAMON MIGUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.