Hidden Lakes Health Center PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

HIDDEN LAKES HEALTH CENTER PLLC

Practice address

8861 Davis Boulevard
Keller, TX 76248

Phone

(817) 753-6561

Fax

(817) 753-6598

NPI assigned

Nov 18, 2010

Organization subpart

No

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

Authorized official

Name

Jeff Henderson

Title

VP

Phone

(972) 401-8720

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1801198221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8861 DAVIS BOULEVARD",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-753-6561",
            "fax_number": "817-753-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8861 DAVIS BOULEVARD",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-753-6561",
            "fax_number": "817-753-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIDDEN LAKES HEALTH CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-18",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "972-401-8720"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Ryan Herring, DC
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• Scott Owen Hickman, PSYD
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• Internal Medicine Physician in Keller, TX
• Providers in Keller, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.