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DR. FREDRIC PUCKETT, PLLC
NPI 1073748562
Family Medicine in Ennis, TX

Active since May 27, 2009CLIA 45D2024029 · Microscopy
2203 W LAMPASAS ST STE 111, ENNIS, TX 75119(972) 875-6200(972) 875-6414 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2024, Apr 5, 2022, Feb 17, 2022 (3 updates tracked since 2022).

About Dr. Fredric Puckett, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. FREDRIC PUCKETT, PLLC (NPI 1073748562) is a healthcare organization registered as a family medicine in Ennis, Texas and active in the NPI registry since May 2009. The organization holds a CLIA Microscopy certificate valid through May 5, 2027 and lists Fredric Clark Puckett, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1073748562
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDR. FREDRIC PUCKETT, PLLC
Location Address2203 W LAMPASAS ST STE 111Ennis, TX 75119-5667
Mailing Address2203 W Lampasas St Ste 111Ennis, TX 75119-5667 · (972) 875-6200 · Fax (972) 875-6414
Phone(972) 875-6200
Fax(972) 875-6414
Organization SubpartNo
Authorized OfficialFredric Clark PuckettPhysician/owner · (972) 875-6200
Enumeration DateMay 27, 2009
Last NPPES UpdateJune 13, 20243 updates tracked since enumeration
NPPES CertifiedApril 5, 2022
✔ NPI 1073748562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
Also ListedPediatricsTaxonomy 208000000X
2203 W LAMPASAS ST STE 111, Ennis, TX 75119
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Other Identifiers 1

Medicaid2080303202TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 45D2024029

Dr Fredric Puckett PLLC · Ennis, TX
Active · expires May 5, 2027
CLIA Number45D2024029
Laboratory TypePhysician Office
Certificate Effective DateMay 6, 2025
Certificate Expiration DateMay 5, 2027
Laboratory DirectorFredric C. Puckett
Laboratory Phone(972) 875-6200
Laboratory LocationDr Fredric Puckett PLLC2203 W Lampasas St, Suite 111, Ennis, TX 75119
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK CHRISTOPHER POLLARD
Nurse Practitioner (Family)
2203 W LAMPASAS ST STE 111
ENNIS, TX 75119
Ellis County (972) 875-0900
LESLIE ELAINE DONET RN, FNP-BC
Nurse Practitioner (Family)
2203 W LAMPASAS ST STE 111
ENNIS, TX 75119
Ellis County (972) 875-6200
HEATHER R HALL MSN, APRN, FNP-C
Nurse Practitioner (Family)
2203 W LAMPASAS ST STE 111
ENNIS, TX 75119
Ellis County (972) 875-6200
MR. LANCE W HALL APRN NP-C, CRNFA
Nurse Practitioner (Family)
2203 W LAMPASAS ST STE 111
ENNIS, TX 75119
Ellis County (972) 875-6200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dr. Fredric Puckett, PLLC's NPI number?

The NPI number for Dr. Fredric Puckett, PLLC is 1073748562. It was assigned to this organization in the NPPES registry on May 27, 2009.

Where is Dr. Fredric Puckett, PLLC located?

Dr. Fredric Puckett, PLLC is located at 2203 W Lampasas St Ste 111, Ennis, TX 75119. The listed phone number is (972) 875-6200.

What is Dr. Fredric Puckett, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Dr. Fredric Puckett, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 45D2024029) is associated with this NPI, valid through May 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dr. Fredric Puckett, PLLC was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.