Individual provider Active NPI

Thomas H. Renard, M.D.

  • Pediatric Surgery Physician
  • Dallas, TX
National Provider Identifier
1770539306
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
H2719 Issued in TX
Practice address
12200 Park Central Dr Ste 400
Dallas, TX 75251-2116
Phone
(214) 483-9300
Fax
(214) 483-9301
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X H2719 TX Primary

Addresses

Primary practice location

12200 Park Central Dr Ste 400
Dallas, TX 75251-2116

Mailing address

12200 Park Central Dr Ste 400
Dallas, TX 75251-2116
Phone (214) 483-9300

Other identifiers 1

IdentifierTypeStateIssuer
1296063-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090527000603 TX Practitioner - Pediatric Medicine 9638112790 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H2719TXMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. CurrentSince Dec 28, 2012 Accepting new patients
Pediatric Surgical Associates Pediatric Surgery PastSince May 10, 2020 Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients

Locations

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

7777 Forest Ln
Ste C150
Dallas, TX 75230
Phone (972) 566-6171

3500 Gaston Ave
Dallas, TX 75246

12200 Park Central Dr
Ste 400
Dallas, TX 75251
Phone (972) 991-5437

5500 Frisco Square Blvd
Frisco, TX 75034
Phone (214) 618-0500

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

11777 FM 1960 Rd W
Houston, TX 77065
Phone (832) 828-3501

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

7000 W Plano Pkwy
Ste 200
Plano, TX 75093

4200 W University Dr
Ste 110
Prosper, TX 75078
Phone (972) 300-0215

4200 W University Dr
Ste 320
Prosper, TX 75078
Phone (469) 344-7667

1005 W Ralph Hall Pkwy
Ste 125
Rockwall, TX 75032
Phone (972) 475-1277

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

8389 S Broadway Ave
Tyler, TX 75703
Phone (903) 606-4129

1120 E Front St
Tyler, TX 75702
Phone (903) 597-7902

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1770539306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "214-483-9300",
            "fax_number": "214-483-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "214-483-9300",
            "fax_number": "214-483-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENARD",
        "first_name": "THOMAS",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "H2719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1296063-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.