Organization Active NPI

Complex Healthcare Physicians Group Inc

  • Vascular Surgery Physician
  • Arlington, TX
National Provider Identifier
1730818527
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
COMPLEX HEALTHCARE PHYSICIANS GROUP INC
Practice address
4201 Interway PL Ste 100
Arlington, TX 76018-5668
Phone
(817) 735-1180
NPI assigned
Jun 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Mr. Glenn Hermes Jr.
Title
President
Phone
(817) 735-1180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

4201 Interway PL Ste 100
Arlington, TX 76018-5668

Mailing address

4201 Interway PL Ste 100
Arlington, TX 76018-5668
Phone (817) 735-1180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221104000706 TX Part B Supplier - Clinic/Group Practice 1951778984 Receives reassigned benefits from 3 practitioners
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory

Locations

4201 Interway Pl
Ste 100
Arlington, TX 76018
Phone (817) 735-1180

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1730818527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 INTERWAY PL STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185668",
            "telephone_number": "817-735-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 INTERWAY PL STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185668",
            "telephone_number": "817-735-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLEX HEALTHCARE PHYSICIANS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-07",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "HERMES",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-735-1180",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.