Individual provider Active NPI

Fang S David, MD

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1710902473
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L6854 Issued in TX
Practice address
1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820
Phone
(817) 820-4906
Fax
(817) 820-4815
NPI assigned
Jul 13, 2006
Last updated
Jul 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X L6854 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820

Mailing address

1300 W Terrell Ave FL 2
Fort Worth, TX 76104-2820
Phone (817) 820-4906

Other identifiers 7

IdentifierTypeStateIssuer
161072706MedicaidTX
161072703MedicaidTX
161072702MedicaidTX
161072705MedicaidTX
161072704MedicaidTX
8B5307OtherTNBCBS
P00126810OtherTXRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505001843 TX Practitioner - Internal Medicine 2567450562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Questcare Hospitalists PLLCGroup PAC ID 5799785119, 266 clinicians

Practice addresses (Care Compare)

2601 W Randol Mill Rd
Arlington, TX 76012-4289
Phone (954) 939-5000

3301 Matlock Rd
Arlington, TX 76015-2908
Phone (682) 509-6200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Hospitalists PLLC Internal Medicine CurrentSince Sep 15, 2018 Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients
Columbia Medical Center of Arlington Subsidiary LP Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients

Locations

2601 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-5571

1950 Record Crossing Rd
Dallas, TX 75235
Phone (214) 638-1500

2301 Marsh Ln
Plano, TX 75093
Phone (972) 428-1600

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1710902473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE FL 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-820-4906",
            "fax_number": "817-820-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE FL 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042820",
            "telephone_number": "817-820-4906",
            "fax_number": "817-820-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "FANG",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L6854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161072706",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161072703",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161072702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161072705",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161072704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8B5307",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00126810",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.