Organization Active NPI

Emcc Pantego Physicians PLLC

  • Emergency Medicine Physician
  • Pantego, TX
National Provider Identifier
1922577170
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMCC PANTEGO PHYSICIANS PLLC
Practice address
1607 S Bowen Rd
Pantego, TX 76013-3337
Phone
(817) 421-0034
Fax
(817) 421-0036
NPI assigned
Nov 16, 2018
Last updated
Sep 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Michelle Newsom
Title
President
Phone
(469) 830-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1607 S Bowen Rd
Pantego, TX 76013-3337

Mailing address

2300 Matlock Rd Ste 35
Mansfield, TX 76063-5018
Phone (469) 830-8200

National Provider Directory

National Provider Directory

Locations

960 Ridgeview Dr
Ste 140125
Allen, TX 75013

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1922577170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MATLOCK RD STE 35",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635018",
            "telephone_number": "469-830-8200",
            "fax_number": "469-830-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 S BOWEN RD",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760133337",
            "telephone_number": "817-421-0034",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMCC PANTEGO PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "NEWSOM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-830-8200"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pantego, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.