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JUSTIN H EZELL D.O. NPI 1740332212


NPI Information

NPI: 1740332212
Provider Name: JUSTIN H EZELL, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: TEXAS HEALTH PHYSICIANS GROUP

PECOS Registration: Yes

Address:
4201 CAMP BOWIE BLVD
FORT WORTH, TX
ZIP 76107
Phone: (817) 731-0801
Get Directions

Justin H Ezell, D.O. is a family medicine in Fort Worth, TX with 8 years of experience. 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. Justin H Ezell, D.O. NPI is 1740332212. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4201 CAMP BOWIE BLVD
FORT WORTH, TX
ZIP 76107-928
Phone: (817) 731-0801
Fax: (817) 731-8468

The NPI 1740332212 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/17/2007 and was last updated on 2/21/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204D00000XNeuromusculoskeletal Medicine & OMMBP10057446TEXASNo
2363A00000XPhysician Assistant1068202No
3207Q00000XFamily MedicineR7207TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1291361803MEDICAIDTEXAS
2291361801MEDICAIDTEXAS
3291361802MEDICAIDTEXAS

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: 11/14/2023

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.