Organization Active NPI

Midland Visiting Doctors Management LLC

  • General Practice Physician
  • Dallas, TX
National Provider Identifier
1851934434
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MIDLAND VISITING DOCTORS MANAGEMENT LLC
Practice address
17330 Preston Rd Ste 170a
Dallas, TX 75252-5796
Phone
(972) 415-9856
NPI assigned
Oct 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Shibu Joseph
Title
Managing Member
Phone
(972) 415-9856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

17330 Preston Rd Ste 170a
Dallas, TX 75252-5796

Mailing address

17330 Preston Rd Ste 170a
Dallas, TX 75252-5796
Phone (469) 242-3826

National Provider Directory

National Provider Directory

Locations

17330 Preston Rd
Ste 170A
Dallas, TX 75252
Phone (469) 242-3826

NPI Registry JSON

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1851934434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17330 PRESTON RD STE 170A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525796",
            "telephone_number": "469-242-3826",
            "fax_number": "469-242-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17330 PRESTON RD STE 170A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525796",
            "telephone_number": "972-415-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND VISITING DOCTORS MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2023-12-06",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "SHIBU",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "972-415-9856"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.