Provider Type Icon

HEALTHCARE ASSOCIATES OF SOUTHLAKE LLP NPI 1043720154


NPI Information

NPI: 1043720154
Provider Name: HEALTHCARE ASSOCIATES OF SOUTHLAKE LLP

Doing Business As: EXECUTIVE MEDICINE OF TEXAS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D1037921

Address:
2106 E STATE HIGHWAY 114
STE 300
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 552-4300
Get Directions

HEALTHCARE ASSOCIATES OF SOUTHLAKE LLP is a family medicine in Southlake, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HEALTHCARE ASSOCIATES OF SOUTHLAKE LLP NPI is 1043720154. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Executive Medicine Of Texas.

The provider's business location address is:

2106 E STATE HIGHWAY 114
STE 300
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 552-4300

The provider's authorized official is Walter Gaman .
The authorized official title is Physician/partner and has the following contact phone number (817) 307-9312.

The CLIA number assigned to this NPI record is 45D1037921 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2017 and was last updated on 10/3/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.