NPIMap

Organization Active NPI

Robert Casey Stroud, D.D.S., P.C.

  • Pediatric Dentistry
  • Willow Park, TX
National Provider Identifier
1760860407
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
ROBERT CASEY STROUD, D.D.S., P.C.
Practice address
134 El Chico TRL
Suite 101
Willow Park, TX 76087-8861
Phone
(817) 441-2425
NPI assigned
May 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Authorized official

Name
Robert Casey StroudNPI 1144367186
Title
Owner/President
Phone
(817) 441-2425

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
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

134 El Chico TRL
Suite 101
Willow Park, TX 76087-8861

Mailing address

134 El Chico TRL
Suite 101
Willow Park, TX 76087-8861
Phone (817) 441-2425

Other identifiers 3

IdentifierTypeStateIssuer
155478403MedicaidTX
195495002MedicaidTX
340688601MedicaidTX

National Provider Directory

National Provider Directory

Locations

134 El Chico Trl
Ste 101
Willow Park, TX 76087
Phone (817) 441-2425

Practitioners & affiliated clinicians

Practitioners 1

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": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1760860407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 EL CHICO TRL",
            "address_2": "SUITE 101",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760878861",
            "telephone_number": "817-441-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 EL CHICO TRL",
            "address_2": "SUITE 101",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760878861",
            "telephone_number": "817-441-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT CASEY STROUD, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "STROUD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CASEY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "817-441-2425"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155478403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195495002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340688601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.