Pediatric Urgent Care Center of Fort Worth, P.a..

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC URGENT CARE CENTER OF FORT WORTH, P.A..

Practice address

3701 Vision Dr Ste 103
Fort Worth, TX 76109-1184

Phone

(817) 259-2365

Fax

(817) 259-2366

NPI assigned

Nov 30, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Michael Ray Cowan, D.O.NPI 1891784377

Title

Owner

Phone

(817) 271-4309

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Fort Worth Concierge Plus Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Telemedicine Advantage Concierge Urgent Care

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1376165191

  Member Of

  NPD member

Locations

Practitioners 7

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

• Michael R Cowan, DO

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1891784377

  Pediatric Emergency Medicine

  Medicare reassignment NPD Authorized official
• Lisa J Herrin, MD

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1366535445

  Pediatric Emergency Medicine

  NPD
• Dallas Nazar, PA-C

  • Physician Assistant
  • Fort Worth, TX
  • NPI 1679284160
  NPD
• Marie Antoinette Nguyen, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Burleson, TX
  • NPI 1578285359
  NPD
• Jamie Marie Underhill, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
  • NPI 1508330838
  NPD
• Leslie Michelle Lynn Alvarez, MSN, RN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Fort Worth, TX
  • NPI 1821595299
  NPD (past)
• Cara Simon, CPNP

  • Pediatric Nurse Practitioner
  • Austin, TX
  • NPI 1457431892
  NPD (past)

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1851668149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 VISION DR STE 103",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091184",
            "telephone_number": "817-259-2365",
            "fax_number": "817-259-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 VISION DR STE 103",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091184",
            "telephone_number": "817-259-2365",
            "fax_number": "817-259-2366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Alemeda St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761084042",
            "country_code": "US",
            "telephone_number": "817-259-2365",
            "fax_number": "817-259-2366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRIC URGENT CARE CENTER OF FORT WORTH, P.A..",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-271-4309",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "H9459",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313997401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Worth Concierge Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pediatric Eye Specialists LLP
• Pediatric Home Healthcare, LLC
• Pediatric Surgical Associates of Ft. Worth, P. a.
• Pediatric Therapy Associates of FW
• Pediatric Therapy Services of Texas
• Pediatric Urgent Care Center of North Texas
• Pediatrix Medical Group of Texas Billing, Inc.
• Pediatrix Medical Group of Texas Billing, Inc.
• Steven Douglas Pedro, M.D.
• Matthew Pedroza, DDS

• Pediatrics Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.