Southlake Orthopedics & Sports Medicine, PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

R0125 Issued in TX

Legal business name

SOUTHLAKE ORTHOPEDICS & SPORTS MEDICINE, PLLC

Doing business as

Summit Orthopedics of Texas

Practice address

800 12TH Ave Ste 200
Fort Worth, TX 76104-2519

Phone

(214) 631-9881

Fax

(972) 438-2077

NPI assigned

Mar 31, 2018

Last updated

May 6, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bantoo Sehgal, MDNPI 1558677690

Title

Owner

Phone

(214) 631-9881

Specialties & licenses 1

Addresses

Other names 1

• Summit Orthopedics of Texas Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Southlake Orthopedics & Sports Medicine, PLLC

  • Orthopaedic Surgery Physician
  • Keller, TX
  • NPI 1740162726

  8426313131

  Same PAC ID

Locations

Practitioners 3

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.

• Bantoo Sehgal, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fort Worth, TX
  • NPI 1558677690
  Medicare reassignment Care Compare group Authorized official
• Paulina Purnama, PA-C

  • Surgical Physician Assistant
  • Fort Worth, TX
  • NPI 1275724981
  Medicare reassignment Care Compare group
• Carl Horton Jr., M.D.

  • Cardiovascular Disease Physician
  • Cleburne, TX
  • NPI 1376528190
  NPD (past)

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1871099739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 12TH AVE STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042519",
            "telephone_number": "214-631-9881",
            "fax_number": "469-482-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 12TH AVE STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042519",
            "telephone_number": "214-631-9881",
            "fax_number": "972-438-2077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 Keller Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Keller",
            "state": "TX",
            "postal_code": "762481620",
            "country_code": "US",
            "telephone_number": "214-631-9881",
            "fax_number": "469-482-2526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHLAKE ORTHOPEDICS & SPORTS MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-31",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "SEHGAL",
        "authorized_official_first_name": "BANTOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-631-9881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "R0125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Orthopedics of Texas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Orthopedics of Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Martin Southard, DO
• Chelsey Southern, PA-C
• Southerncare Inc (SouthernCare Ft Worth)
• Southlake Dental Corp
• Southlake Neuromonitoring LLC
• Southlake Premier Anesthesia, PLLC
• Southlake Rheumatology and Endocrinology Specialists, PLLC (ArthritisPlus Rheumatology & Osteoporosis Center)
• Southside Acupuncture, PLLC
• Southside Adult Daycare Center, Inc.
• Southstar Counseling LLC

• Orthopaedic Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.