NPIMap

Organization Active NPI

RG Medical

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1962645754
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D6175 Issued in TX
Legal business name
RG MEDICAL
Practice address
4716 E Lancaster Ave
Fort Worth, TX 76103-3836
Phone
(817) 413-8000
NPI assigned
Apr 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Authorized official

Name
Shirley Odiwuor
Title
Manager
Phone
(817) 413-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D6175 TX Primary

Addresses

Primary practice location

4716 E Lancaster Ave
Fort Worth, TX 76103-3836

Mailing address

4716 E Lancaster Ave
Fort Worth, TX 76103-3836

National Provider Directory

National Provider Directory

Locations

4716 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 413-8000

Practitioners & affiliated clinicians

Practitioners 4

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": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1962645754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4716 E LANCASTER AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033836",
            "telephone_number": "817-413-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RG MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "ODIWUOR",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-413-8000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D6175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; 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.