NPIMap

Organization Active NPI

Cowtown Pediatrix Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1821489121
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COWTOWN PEDIATRIX CLINIC, LLC
Practice address
4011 Benbrook Hwy Ste C
Fort Worth, TX 76116-7800
Phone
(817) 386-5500
Fax
(817) 386-5500
NPI assigned
Feb 9, 2015
Last updated
Apr 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Authorized official

Name
Sue KhammarNPI 1003230822
Title
President/Manager
Phone
(871) 386-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4011 Benbrook Hwy Ste C
Fort Worth, TX 76116-7800

Mailing address

4011 Benbrook Hwy Ste C
Fort Worth, TX 76116-7800
Phone (817) 386-5500

National Provider Directory

National Provider Directory

Locations

4011 Benbrook Hwy
Ste C
Ft Worth, TX 76116
Phone (817) 386-5500

Practitioners & affiliated clinicians

Practitioners 9

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": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1821489121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 BENBROOK HWY STE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167800",
            "telephone_number": "817-386-5500",
            "fax_number": "817-386-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 BENBROOK HWY STE C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167800",
            "telephone_number": "817-386-5500",
            "fax_number": "817-386-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COWTOWN PEDIATRIX CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "KHAMMAR",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT/MANAGER",
        "authorized_official_telephone_number": "871-386-5500"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.