Alliance Primary Care Assoc PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L8824 Issued in TX

Legal business name

ALLIANCE PRIMARY CARE ASSOC PLLC

Practice address

12461 Timberland Blvd
Suite 309
Fort Worth, TX 76244-5213

Phone

(817) 741-5437

Fax

(817) 431-5870

NPI assigned

Jun 19, 2012

Last updated

Aug 16, 2016By 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

Bruce Martin, M.D.NPI 1043390974

Title

Ceo

Phone

(817) 741-5437

Specialties & licenses 1

Addresses

Locations

Practitioners 6

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.

• Bruce D Martin, MD

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1043390974
  NPD (past) Authorized official
• Courtney M Carter, DO

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1366627655
  NPD (past)
• Susanna Chandler, DO

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1356970438
  NPD (past)
• Katherine Ann Ghanayem, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1609037100
  NPD (past)
• Michael Gronberg, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1639127715
  NPD (past)
• Jana Robertson, M.D.

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1184836181
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1912260506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12461 TIMBERLAND BLVD",
            "address_2": "SUITE 309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445213",
            "telephone_number": "817-741-5437",
            "fax_number": "817-431-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12461 TIMBERLAND BLVD",
            "address_2": "SUITE 309",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445213",
            "telephone_number": "817-741-5437",
            "fax_number": "817-431-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PRIMARY CARE ASSOC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-741-5437",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L8824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alliance Medical Weight Loss Clinic (Alliance Medical Spa)
• Alliance Network
• Alliance Ophthalmology, PLLC (Alliance Vision Institute)
• Alliance Oral & Maxillofacial Surgery, P.a. (Alliance Oral & Maxillofacial Surgery)
• Alliance Pharmacy LLC (Alliance Pharmacy)
• Alliance Retina of Texas, PLLC (Alliance Retina)
• Alliance Service Organization
• Alliance Total Wellness, PLLC
• Allied Living Solutions (Pullam&Smith Allied Living Solutions)
• Allison Readinger MD PA (Trinity Vista Dermatology)

• 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 Aug 16, 2016; 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.