NPIMap

Organization Active NPI

Plaza Primary Care PLLC

  • Family Medicine Physician
  • Burleson, TX
National Provider Identifier
1720223662
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLAZA PRIMARY CARE PLLC
Practice address
1571 SW Wilshire Blvd
Suite 500
Burleson, TX 76028-8716
Phone
(817) 295-1121
Fax
(817) 295-8170
NPI assigned
Dec 5, 2008
Last updated
Feb 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Authorized official

Name
Jeff Henderson
Title
President
Phone
(972) 401-8726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1571 SW Wilshire Blvd
Suite 500
Burleson, TX 76028-8716

Mailing address

1571 SW Wilshire Blvd
Suite 500
Burleson, TX 76028-8716
Phone (817) 295-1121

National Provider Directory

National Provider Directory

Locations

1571 SW Wilshire Blvd
Ste 500
Burleson, TX 76028
Phone (817) 295-1121

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1720223662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 SW WILSHIRE BLVD",
            "address_2": "SUITE 500",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288716",
            "telephone_number": "817-295-1121",
            "fax_number": "817-295-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 SW WILSHIRE BLVD",
            "address_2": "SUITE 500",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288716",
            "telephone_number": "817-295-1121",
            "fax_number": "817-295-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-401-8726"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.