Organization Active NPI

Samer M. Nachawati, LLC

  • Internal Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1740717545
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q9689 Issued in TX
Legal business name
SAMER M. NACHAWATI, LLC
Practice address
1817 Independence CT
Grand Prairie, TX 75052-1914
Phone
(214) 535-7892
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Dr. Samer Nachawati, D.O.NPI 1073652806
Title
Member
Phone
(214) 535-7892

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Q9689 TX Primary

Addresses

Primary practice location

1817 Independence CT
Grand Prairie, TX 75052-1914

Mailing address

1817 Independence CT
Grand Prairie, TX 75052-1914

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170609000583 TX Part B Supplier - Clinic/Group Practice 3870861180 Receives reassigned benefits from 1 practitioner
Practice locations: Mesquite, TX

National Provider Directory

National Provider Directory

Locations

929 N Galloway Ave
Ste 102
Mesquite, TX 75149
Phone (972) 329-8200

3330 N Galloway Ave
Ste 304
Mesquite, TX 75150
Phone (214) 875-3695

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1740717545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 INDEPENDENCE CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 INDEPENDENCE CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521914",
            "telephone_number": "214-535-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMER M. NACHAWATI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "NACHAWATI",
        "authorized_official_first_name": "SAMER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "214-535-7892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q9689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.