Organization Active NPI

White Rock Pulmonary Associates, P.a.

  • Pulmonary Disease Physician
  • Dallas, TX
National Provider Identifier
1790718484
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
J5758 Issued in TX
Legal business name
WHITE ROCK PULMONARY ASSOCIATES, P.A.
Practice address
9330 Poppy Drive
Suite #407
Dallas, TX 75218-3403
Phone
(214) 328-5487
Fax
(214) 328-0419
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Mr. Mark C. Ferris, M.D.
Title
President
Phone
(214) 328-5487

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X J5758 TX
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X J5758 TX Primary

Addresses

Primary practice location

9330 Poppy Drive
Suite #407
Dallas, TX 75218-3403

Mailing address

9330 Poppy Drive
Suite #407
Dallas, TX 75218-3403
Phone (214) 328-5487

Other identifiers 2

IdentifierTypeStateIssuer
079894401MedicaidTX
115596203MedicaidTX

National Provider Directory

National Provider Directory

Locations

9330 Poppy Dr
Ste 407
Dallas, TX 75218
Phone (214) 328-5487

9330 Poppy Dr
Ste 4
Dallas, TX 75218
Phone (214) 328-5487

Practitioners & affiliated clinicians

Practitioners 2

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1790718484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 POPPY DRIVE",
            "address_2": "SUITE #407",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183403",
            "telephone_number": "214-328-5487",
            "fax_number": "214-328-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 POPPY DRIVE",
            "address_2": "SUITE #407",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183403",
            "telephone_number": "214-328-5487",
            "fax_number": "214-328-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE ROCK PULMONARY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "FERRIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-328-5487",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "J5758",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "J5758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079894401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115596203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.