FAIRWAY FAMILY MEDICINE-PRIMARY CARE, PLLC (NPI# 1508115718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508115718 |
| Entity Type | Organization |
| Organization Name | FAIRWAY FAMILY MEDICINE-PRIMARY CARE, PLLC |
| Practice Address |
4100 Fairway Dr 320 Carrollton TX 75010-6525 |
| Practice Telephone | 9722367608 |
| Mailing Telephone | 9722367608 |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |
| Authorized Official Name | DR. HONG XIAO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4698789480 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
L3196 | TX | Ambulatory Health Care Facilities |
| Street Address |
4100 FAIRWAY DR 320 |
| City | CARROLLTON |
| State | TX |
| Zip Code | 75010-6525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316944366 | Alison Jennifer Taylor | Occupational Therapist | 4100 Fairway Dr, Ste 400, Carrollton, TX 75010-6525 | 2005-07-06 |
| 1144777814 | Amanda M Warneke | Physician Assistant | 4100 Fairway Dr, Suite 100, Carrollton, TX 75010-6525 | 2016-09-09 |
| 1093174062 | Jessica M. Novak | Physical Therapist | 4100 Fairway Dr, Suite 400, Carrollton, TX 75010-6525 | 2016-02-18 |
| 1851715304 | Tms Neuro Solutions, LLC | Clinic/Center | 4100 Fairway Dr, Suite 200, Carrollton, TX 75010-6525 | 2014-02-04 |
| 1821340472 | Fairway Pediatrics, Pllc | Pediatrics | 4100 Fairway Dr, Suite 300, Carrollton, TX 75010-6525 | 2012-10-06 |
| 1992071724 | Thomas Adams | Physical Therapist | 4100 Fairway Dr, Suite 400, Carrollton, TX 75010-6525 | 2012-03-27 |
| 1134491046 | Summit Behavioral Health Pllc | Psychiatry & Neurology | 4100 Fairway Dr, Bldg # 200, Carrollton, TX 75010-6525 | 2012-02-08 |
| 1093099558 | Realtime Laboratories, Inc | Clinical Medical Laboratory | 4100 Fairway Dr, Ste 600, Carrollton, TX 75010-6525 | 2011-10-03 |
| 1982907465 | Lisa Renee Reznick Md, Pa | Durable Medical Equipment & Medical Supplies | 4100 Fairway Dr, Suite 120, Carrollton, TX 75010-6525 | 2010-12-06 |
| 1508910316 | Charles Steven Manley | Psychologist | 4100 Fairway Dr, Ste. 200, Carrollton, TX 75010-6525 | 2007-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043782907 | Timothy C. Pringle Md Pa | Surgery | 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 | 2018-12-17 |
| 1184106411 | Cindy T Vu | Occupational Therapy Assistant | 1877 Cheyenne, Carrollton, TX 75010 | 2018-09-04 |
| 1639686256 | Little Lantern Hospice LLC | Hospice Care, Community Based | 4541 North Josey Lane, Suite 110-b, Carrollton, TX 75010 | 2018-01-04 |
| 1235681610 | Kahini Shah | Physical Therapist | 1012 W Hebron Pkwy Ste 124, Carrollton, TX 75010 | 2016-11-01 |
| 1881148849 | Wais Azesh | Dentist | 1233 Apache Lake Dr, Carrollton, TX 75010 | 2016-08-08 |
| 1225485055 | Julia Buckelew | Physical Therapist | 4100 Fairway Dr Ste 400, Carrollton, TX 75010 | 2016-05-23 |
| 1811355639 | Fastpass Ucc, Pllc | Clinic/Center | 4228 N Josey Ln Ste 150, Carrollton, TX 75010 | 2016-02-08 |
| 1326404393 | Miaojuan Li | Nurse Practitioner | 4100 Fairway Dr Ste 300, Carrollton, TX 75010 | 2016-01-06 |
| 1912376112 | Envoy Hospice North LLC | Hospice Care, Community Based | 4040 Tx-121, Carrollton, TX 75010 | 2015-09-17 |
| 1932593936 | Lifeway Hospice, LLC | Hospice Care, Community Based | 4040 State Highway 121, Suite 140, Carrollton, TX 75010 | 2015-03-27 |
| Find all providers in zip 75010 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740814532 | Njp Pllc | Clinic/Center | 1790 King Arthur Blvd Ste 140, Carrollton, TX 75010-2041 | 2020-03-02 |
| 1598316275 | Careatc | Clinic/Center | 1735 Keller Springs Rd Ste 100, Carrollton, TX 75006-2999 | 2019-09-24 |
| 1013463488 | Kuraoka Clinic Texas, Pllc | Clinic/Center | 3012 E Hebron Pkwy Ste 104, Carrollton, TX 75010-4461 | 2016-08-26 |
| 1417311382 | Mainmedplus Pllc | Clinic/Center | 3044 Old Denton Rd Ste 115, Carrollton, TX 75007-5074 | 2016-04-07 |
| 1306190921 | Pickens County Health Care Authority | Clinic/Center | 289 William E Hill Dr Ste C, Carrollton, AL 35447-3247 | 2012-11-05 |
| 1013407451 | Renovar Wellcare Pllc | Clinic/Center | 4217 Marsh Ridge Rd Ste 100, Carrollton, TX 75010 | 2018-05-10 |
| 1568816296 | Mainmedplus Pllc | Clinic/Center | 3044 Old Denton Rd Ste 115, Carrollton, TX 75007-5074 | 2016-04-19 |
| 1417316159 | Us Medclinic LLC | Clinic/Center | 714 Cedar St, Carrollton, GA 30117-2415 | 2016-02-22 |
| 1144689373 | Mainmedplus | Clinic/Center | 3044 Old Denton Rd, Ste 115, Carrollton, TX 75007-5016 | 2016-02-16 |
| 1326368168 | Najam Khan Mdpa | Clinic/Center | 4325 N Josey Ln, Suite 301, Carrollton, TX 75010-4635 | 2010-06-03 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 75010 |
Please comment or provide details below to improve the information on FAIRWAY FAMILY MEDICINE-PRIMARY CARE, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.