Individual provider Active NPI

Thomas A Hargrove, MD

  • Pediatrics Physician
  • Tyler, TX
National Provider Identifier
1902870272
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H5776 Issued in TX
Practice address
706 Turtle Creek Dr
Tyler, TX 75701-1833
Phone
(903) 595-3942
NPI assigned
Feb 14, 2006
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H5776 TX Primary

Addresses

Primary practice location

706 Turtle Creek Dr
Tyler, TX 75701-1833

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450

Other practice location 1

3593 E Grande Blvd
Tyler, TX 75707-1400
Phone (903) 839-2585

Other practice location 2

3203 S Main St
Lindale, TX 75771-7727
Phone (903) 882-7717

Other identifiers 3

IdentifierTypeStateIssuer
136209711MedicaidTX
136209712MedicaidTX
136209706MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090324000252 TX Practitioner - Pediatric Medicine 8224095971 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Jacksonville CurrentSince Mar 1, 2020 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Mar 1, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jul 1, 2007 Accepting new patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Jul 1, 2007 Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

706 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 595-3942

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

Interoperability endpoints

  • Direct secure messaging: thargrove2646@christushealth.direct-ci.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1902870272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011833",
            "telephone_number": "903-595-3942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3203 S Main St",
            "address_purpose": "LOCATION",
            "city": "Lindale",
            "state": "TX",
            "postal_code": "757717727",
            "country_code": "US",
            "telephone_number": "903-882-7717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "THOMAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H5776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136209711",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136209712",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136209706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.