Thor Medical Association

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THOR MEDICAL ASSOCIATION

Practice address

1121 N Joe Wilson Rd
Cedar Hill, TX 75104-1430

Phone

(972) 291-1531

Fax

(972) 291-1646

NPI assigned

Nov 16, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Gloria L Bergman

Title

Office Manager

Phone

(972) 291-1531

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cedar Hill Medical & Surgical Center Doing business as

Locations

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1821279969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 N JOE WILSON RD",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751041430",
            "telephone_number": "972-291-1531",
            "fax_number": "972-291-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 N JOE WILSON RD",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751041430",
            "telephone_number": "972-291-1531",
            "fax_number": "972-291-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOR MEDICAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "972-291-1531",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035630501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0095KG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Hill Medical & Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Cedar Hill, TX
• Providers in Cedar Hill, 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 Dec 17, 2008; 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.