Individual provider Active NPI

Dale G Swanholm, M.D.

  • Family Medicine Physician
  • Highland Village, TX
National Provider Identifier
1730187444
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E5263 Issued in TX
Practice address
2300 Highland Village Rd
Ste 600
Highland Village, TX 75077-7148
Phone
(972) 317-0331
Fax
(972) 317-3811
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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 E5263 TX Primary

Addresses

Primary practice location

2300 Highland Village Rd
Ste 600
Highland Village, TX 75077-7148

Mailing address

2300 Highland Village Rd
Ste 600
Highland Village, TX 75077-8102
Phone (972) 317-0331

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dale.swanholm@pa.eclinicaldirectplus.com Health Information Exchange (HIE)

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
I20100225000366 TX Practitioner - Family PracticePractitioner - Geriatric Medicine 7012051238

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E5263TXMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: dale.swanholm@pa.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1730187444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HIGHLAND VILLAGE RD",
            "address_2": "STE 600",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750778102",
            "telephone_number": "972-317-0331",
            "fax_number": "972-317-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HIGHLAND VILLAGE RD",
            "address_2": "STE 600",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750777148",
            "telephone_number": "972-317-0331",
            "fax_number": "972-317-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANHOLM",
        "first_name": "DALE",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E5263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dale.swanholm@pa.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2300 Highland Village Rd",
            "address_2": "STE 600",
            "city": "Highland Village",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750777148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Highland Village, TX

Sources for this page

Verify at the official NPI Registry.