NPIMap

Organization Active NPI

West Texas Counseling and Rehabilitation of Dallas, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dallas, TX
National Provider Identifier
1881725752
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
0000050 Issued in TX
Legal business name
WEST TEXAS COUNSELING AND REHABILITATION OF DALLAS, INC.
Practice address
1808 Market Center Blvd
Dallas, TX 75207-3315
Phone
(214) 630-7146
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Ivan Garcia, MDNPI 1649596974
Title
President
Phone
(214) 630-7146

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 0000050 TX Primary

Addresses

Primary practice location

1808 Market Center Blvd
Dallas, TX 75207-3315

Mailing address

PO Box 303249
Austin, TX 78703-0055

Other names 1

  • WTCR Dallas, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200206000307 TX Part B Supplier - Opioid Treatment Program (Otp) 7416177167 Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1881725752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303249",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787030055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 MARKET CENTER BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752073315",
            "telephone_number": "214-630-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS COUNSELING AND REHABILITATION OF DALLAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-630-7146",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "0000050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WTCR Dallas, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WTCR Dallas, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 29, 2021; 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.