Organization Active NPI

North Dallas Medical Group, PLLC

Doing business as InnovareTx Regenerative & Wellness Clinic

  • Multi-Specialty Clinic/Center
  • Addison, TX
National Provider Identifier
1790005734
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NORTH DALLAS MEDICAL GROUP, PLLC
Doing business as
InnovareTx Regenerative & Wellness Clinic
Practice address
16901 Dallas Pkwy Ste 206
Addison, TX 75001-5214
Phone
(214) 233-3094
Fax
(214) 241-1167
NPI assigned
Jun 1, 2010
Last updated
May 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Mrs. Zenia C Ortega
Title
Practice Manager
Phone
(214) 233-3094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

16901 Dallas Pkwy Ste 206
Addison, TX 75001-5214

Mailing address

7224 Canongate Dr
Dallas, TX 75248
Phone (241) 244-6171

Other identifiers 1

IdentifierTypeStateIssuer
PA02353OtherTXTEXAS MEDICAL BOARD

Other names 1

  • InnovareTx Regenerative & Wellness Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250422002676 TX Part B Supplier - Clinic/Group Practice 0749705762 Receives reassigned benefits from 2 practitioners
Practice locations: Addison, 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
45D2324901North Dallas Medical Group16901 Dallas Parkway Suite 206, Addison, TX 75001Certificate of waiverJun 2, 2027

National Provider Directory

National Provider Directory

Locations

16901 Dallas Pkwy
Ste 210
Addison, TX 75001
Phone (214) 233-3094

6025 Royal Ln
Bldg 219
Dallas, TX 75230

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1790005734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7224 CANONGATE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75248",
            "telephone_number": "241-244-6171",
            "fax_number": "972-733-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16901 DALLAS PKWY STE 206",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750015214",
            "telephone_number": "214-233-3094",
            "fax_number": "214-241-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DALLAS MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "ZENIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "214-233-3094",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA02353",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InnovareTx Regenerative & Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; 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.