Stephenville Complete UC & Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STEPHENVILLE COMPLETE UC & FAMILY MEDICINE PLLC

Practice address

2108 W Washington St
Stephenville, TX 76401-3928

Phone

(817) 421-0012

Fax

(817) 421-0036

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Braxton Neiman

Title

General Counsel

Phone

(817) 421-0034

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Jordan, FNP-C

  • Nurse Practitioner
  • Stephenville, TX
  • NPI 1679033476
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1811423965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S KIMBALL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929016",
            "telephone_number": "817-421-0012",
            "fax_number": "817-421-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 W WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013928",
            "telephone_number": "817-421-0012",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENVILLE COMPLETE UC & FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "NEIMAN",
        "authorized_official_first_name": "BRAXTON",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "817-421-0034"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Louis Stava, PA-C
• Jacek Stepczynski, PT
• Stephen'S Health Care, Inc.
• Stephens Memorial Hospital District
• Stephenville 2108 ER Physicians PLLC
• Stephenville Dental, PLLC
• Stephenville Eye Center, PLLC
• Stephenville Family Dentistry
• Stephenville Family Dentistry, Inc.
• Stephenville I Enterprises, LLC

• Family Medicine Physician in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.