The Physicians Clinic PA

Key facts

NPI

1992818181

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

Legal business name

THE PHYSICIANS CLINIC PA

Practice address

13082 County Road 2320
Tyler, TX 75707-5914

Phone

(903) 245-9647

NPI assigned

Aug 15, 2006

Organization subpart

No

Authorized official

Name

Andrew E Bentley, MD

Title

President

Phone

(903) 245-9647

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2013.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1992818181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13082 COUNTY ROAD 2320",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757075914",
            "telephone_number": "903-245-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13082 COUNTY ROAD 2320",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757075914",
            "telephone_number": "903-245-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHYSICIANS CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-245-9647",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159935901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0056JF",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Tyler, TX · Family Medicine Physician in Texas