Organization Active NPI

Vascular Care of Texas, PLLC

  • Vascular Surgery Physician
  • Garland, TX
National Provider Identifier
1982095329
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR CARE OF TEXAS, PLLC
Practice address
601 Clara Barton Blvd Ste 350
Garland, TX 75042-5747
Phone
(972) 426-9900
Fax
(972) 426-9899
NPI assigned
Feb 6, 2015
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Edic Stephanian, MDNPI 1871543660
Title
President
Phone
(972) 426-9900

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
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

601 Clara Barton Blvd Ste 350
Garland, TX 75042-5747

Mailing address

601 Clara Barton Blvd Ste 350
Garland, TX 75042-5747
Phone (972) 426-9900

Other identifiers 1

IdentifierTypeStateIssuer
348242401MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150402001421 TX Part B Supplier - Clinic/Group Practice 9133446081 Receives reassigned benefits from 4 practitioners
Practice locations: Plano, TX; McKinney, TX; Garland, TX

National Provider Directory

National Provider Directory

Locations

1705 Ohio Dr
Plano, TX 75093

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDADA

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1982095329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CLARA BARTON BLVD STE 350",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750425747",
            "telephone_number": "972-426-9900",
            "fax_number": "972-426-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CLARA BARTON BLVD STE 350",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750425747",
            "telephone_number": "972-426-9900",
            "fax_number": "972-426-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR CARE OF TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-06",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "STEPHANIAN",
        "authorized_official_first_name": "EDIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-426-9900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348242401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.