NPIMap

Organization Active NPI

Ctvhs

  • Internal Medicine Physician
  • Temple, TX
National Provider Identifier
1740291343
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
023405 Issued in LA
Legal business name
CTVHS
Practice address
1901 S 1St St
111 GM-T
Temple, TX 76504-7451
Phone
(254) 743-2300
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bruce Gordon, M.D
Title
Staff Physician
Phone
(254) 743-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 023405 LA Primary

Addresses

Primary practice location

1901 S 1St St
111 GM-T
Temple, TX 76504-7451

Mailing address

1901 S 1St St
111 GM-T
Temple, TX 76504-7451
Phone (254) 743-2300

Other identifiers 1

IdentifierTypeStateIssuer
023405OtherLASTATE LICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
James a Haley Veterans' Hospital179 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1901 S 1st St
#111
Temple, TX 76504
Phone (254) 743-0885

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740291343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S 1ST ST",
            "address_2": "111 GM-T",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-743-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S 1ST ST",
            "address_2": "111 GM-T",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-743-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CTVHS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "STAFF PHYSICIAN",
        "authorized_official_telephone_number": "254-743-2300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "023405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "023405",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.