Organization Active NPI

Texas Centers for Infectious Disease Associates PA

  • Infectious Disease Physician
  • Fort Worth, TX
National Provider Identifier
1750332441
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
TEXAS CENTERS FOR INFECTIOUS DISEASE ASSOCIATES PA
Practice address
1025 College Ave
Fort Worth, TX 76104-3013
Phone
(817) 810-9811
Fax
(817) 810-9815
NPI assigned
May 15, 2006
Last updated
Jan 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
Cheryl Kay McDonald, MDNPI 1013982511
Title
Provider
Phone
(817) 810-9810

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X Primary
Community/Retail Pharmacy 3336C0003X
Home Infusion Therapy Pharmacy 3336H0001X

Addresses

Primary practice location

1025 College Ave
Fort Worth, TX 76104-3013

Mailing address

1025 College Ave
Fort Worth, TX 76104-3013
Phone (817) 810-9810

Other identifiers 3

IdentifierTypeStateIssuer
079871202MedicaidTX
00099KOtherTXBCBS GROUP
CH8204OtherMEDICARE RR GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000462 TX Part B Supplier - Clinic/Group Practice 4880596451 Receives reassigned benefits from 26 practitioners
Practice locations: Dallas, TX; Fort Worth, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0948775Texas Centers for Infectious Disease1025 College Ave, Fort Worth, TX 76104Certificate of waiverJul 19, 2026

National Provider Directory

National Provider Directory

Locations

3410 Worth St
Ste 740
Dallas, TX 75246

3410 Worth St
Ste 780
Dallas, TX 75246
Phone (817) 810-9810

3410 Worth St
Ste 780790
Dallas, TX 75246
Phone (214) 716-0662

3410 Worth St
Ste 790
Dallas, TX 75246
Phone (817) 810-9810

1025 College Ave
Ste 104
Fort Worth, TX 76104
Phone (817) 810-9810

1124 College Ave
Ft Worth, TX 76104
Phone (817) 336-5466

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1750332441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043013",
            "telephone_number": "817-810-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043013",
            "telephone_number": "817-810-9811",
            "fax_number": "817-810-9815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS CENTERS FOR INFECTIOUS DISEASE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "817-810-9810",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079871202",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "00099K",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP",
            "identifier": "CH8204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.