PSN FW Holdco, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PSN FW HOLDCO, LLC

Practice address

975 Haskell Street
Fort Worth, TX 76107

Phone

(817) 945-8000

Fax

(817) 945-9679

NPI assigned

Feb 14, 2018

Organization subpart

No

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

Authorized official

Name

Jordan Fowler

Title

Ceo

Phone

(917) 216-6285

Specialties & licenses 1

Addresses

Practitioners 1

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

• Omar A Haq, MD

  • Transplant Hepatology Physician
  • Fort Worth, TX
  • NPI 1477723344
  NPD (past)

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1740780956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ENCHANTED WAY SUITE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "682-223-5552",
            "fax_number": "682-223-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 HASKELL STREET",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76107",
            "telephone_number": "817-945-8000",
            "fax_number": "817-945-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSN FW HOLDCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-216-6285"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanika A Pryor
• Rachel Pryor
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• Psap Neuromonitoring LLC
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• Katina Psomiadis, SLP
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• Psy Family Services
• Psychiatric Consultants of Ft Worth PA
• Psychotherapy Services & Yokefellows

• Ambulatory Surgical Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.