Organization Active NPI

Texas Health Care, P.L.L.C.

  • Advanced Practice Midwife
  • Fort Worth, TX
National Provider Identifier
1831255132
Registry record updated Oct 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Legal business name
TEXAS HEALTH CARE, P.L.L.C.
Practice address
1650 W. Magnolia
Suite 212
Fort Worth, TX 76104-4011
Phone
(817) 923-3633
Fax
(817) 923-3504
NPI assigned
Dec 29, 2006
Last updated
Oct 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2011

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

Authorized official

Name
Larry D. Tatum, M.D.NPI 1437195609
Title
C.E.O.
Phone
(817) 740-8400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NU Primary

Addresses

Primary practice location

1650 W. Magnolia
Suite 212
Fort Worth, TX 76104-4011

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other identifiers 2

IdentifierTypeStateIssuer
155109501MedicaidTX
45D0900924OtherTXCLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000388 TX Part B Supplier - Clinic/Group Practice 7214840867 Receives reassigned benefits from 544 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

1650 W Magnolia Ave
Ste 212
Fort Worth, TX 76104
Phone (817) 923-3633

Practitioners & affiliated clinicians

Practitioners 1

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": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318636800000",
    "number": "1831255132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-378-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W. MAGNOLIA",
            "address_2": "SUITE 212",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044011",
            "telephone_number": "817-923-3633",
            "fax_number": "817-923-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS HEALTH CARE, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2011-10-15",
        "status": "A",
        "authorized_official_last_name": "TATUM",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "817-740-8400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155109501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D0900924",
            "state": "TX"
        }
    ],
    "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 Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.