NPIMap

Organization Active NPI

Doctors Urgent Care of Northlake PLLC

  • Urgent Care Clinic/Center
  • Northlake, TX
National Provider Identifier
1912612920
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
DOCTORS URGENT CARE OF NORTHLAKE PLLC
Practice address
1234 FM 407 W Ste 200
Northlake, TX 76226-5734
Phone
(940) 222-5215
Fax
(940) 239-3686
NPI assigned
Jan 16, 2023
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Bobbie Kumar, MDNPI 1275789190
Title
Owner/Member
Phone
(940) 222-5215

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1234 FM 407 W Ste 200
Northlake, TX 76226-5734

Mailing address

1234 FM 407 W Ste 200
Northlake, TX 76226-5734
Phone (940) 222-5215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230221000879 TX Part B Supplier - Clinic/Group Practice 5294107249 Receives reassigned benefits from 22 practitioners
Practice locations: Northlake, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2278488Doctors Urgent Care of Northlake1234 FM 407 Suite 200, Northlake, TX 76226Certificate of waiverMar 16, 2027

National Provider Directory

National Provider Directory

Locations

1234 FM 407 W
Ste 200
Northlake, TX 76226
Phone (940) 222-5215

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1912612920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 FM 407 W STE 200",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "762265734",
            "telephone_number": "940-222-5215",
            "fax_number": "940-239-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FM 407 W STE 200",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "762265734",
            "telephone_number": "940-222-5215",
            "fax_number": "940-239-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS URGENT CARE OF NORTHLAKE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "940-222-5215",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.