EXECUTIVE MEDICINE OF TEXAS
NPI 1043720154
Family Medicine in Southlake, TX

NPI Status: Active since October 03, 2017

Contact Information

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

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  • Organization
  • Family Medicine
  • CLIA Number: 45D1037921
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 10-28-2027

About EXECUTIVE MEDICINE OF TEXAS

This page provides the complete NPI Profile along with additional information for Executive Medicine Of Texas, a primary care provider established in Southlake, Texas operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1043720154 assigned on October 2017. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Executive Medicine Of Texas. The authorized official of this NPI record is Walter Gaman Md (Physician/partner)

NPI
1043720154
Provider Legal Name
HEALTHCARE ASSOCIATES OF SOUTHLAKE LLP
Other Organization Name
EXECUTIVE MEDICINE OF TEXAS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2106 E STATE HIGHWAY 114 STE 300 SOUTHLAKE, TX 76092
Location Phone
(817) 552-4300
Mailing Address
2106 E STATE HIGHWAY 114 STE 300 SOUTHLAKE, TX 76092
Mailing Phone
(817) 552-4300
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-03-2017
Last Update Date
10-03-2017
Code Navigator

A primary care provider (PCP) like Executive Medicine Of Texas sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

WALTER GAMAN MD

Authorized Official Title
PHYSICIAN/PARTNER
Authorized Official Phone
(817) 307-9312

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D1037921
Facility Type
Physician Office
Certificate Effective Date
October 29, 2025
Certificate Expiration Date
October 28, 2027
Laboratory Director
WALTER N. GAMAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Executive Medicine Of Texas to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1043720154, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
2
Unchanged
Pos 7
0
Doubled → 0
Pos 8
1
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 7 → 14 → 5 0 → 0 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 8 + 3 + 1 + 4 + 2 + 0 + 1 + 1 + 0 + 24 = 46

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1043720154.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043720154, enumerated as an "organization" on October 03, 2017.

The provider is located at 2106 E STATE HIGHWAY 114 STE 300 SOUTHLAKE, TX 76092 and the phone number is (817) 552-4300.

Family Medicine with taxonomy code 207Q00000X.