FORT WORTH ENT, PA
NPI 1336353366
Specialist in Fort Worth, TX
NPI Status: Active since May 09, 2007
Contact Information
1250 8TH AVE
SUITE 135
FORT WORTH, TX
ZIP 76104
Phone: (817) 335-8151
Fax: (817) 335-2670
- Organization
- Specialist
- CLIA Number: 45D2250964
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 01-30-2028
About FORT WORTH ENT, PA
This page provides the complete NPI Profile along with additional information for Fort Worth Ent, Pa, a provider established in Fort Worth, Texas operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1336353366 assigned on May 2007. The practitioner's primary taxonomy code is 174400000X with license number H2007 (TX). The provider is registered as an organization and their NPI record was last updated 15 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 Fort Worth Ent, Pa. The authorized official of this NPI record is Mrs. Vicky L. Vanvleck (Practice Manager)
- NPI
- 1336353366
- Provider Legal Name
- FORT WORTH ENT,P.A.
- Other Organization Name
- FORT WORTH ENT, PA
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1250 8TH AVE SUITE 135 FORT WORTH, TX 76104
- Location Phone
- (817) 335-8151
- Location Fax
- (817) 335-2670
- Mailing Address
- 1250 8TH AVE SUITE 135 FORT WORTH, TX 76104
- Mailing Phone
- (817) 335-8151
- Mailing Fax
- (817) 335-2670
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-09-2007
- Last Update Date
- 01-24-2011
- Code Navigator
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
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- H2007
- License State
- TX
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 174400000X | Other Service Providers | Specialist | L4150 (TX) |
Group Taxonomy 193400000X MULTIPLE 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8G2131 | OTHER (01) | TX | TODD E. SAMUELSON MD BCBS |
| H2007 | OTHER (01) | TX | TODD E SAMUELSON MD LICEN |
| 8K1145 | MEDICARE PIN (08) | TX | |
| H58176 | MEDICARE UPIN (02) | TX | |
| D67714 | MEDICARE UPIN (02) | TX | |
| 031074002 | MEDICAID (05) | TX | |
| 8A1828 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | TODD E. SAMUELSON MD |
| 166927701 | MEDICAID (05) | TX | |
| 8L17055 | MEDICARE PIN (08) | TX |
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
- 45D2250964
- Facility Type
- Independent
- Certificate Effective Date
- January 31, 2026
- Certificate Expiration Date
- January 30, 2028
- Laboratory Director
- JERRY BOONYARATANAKORNIT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Fort Worth Ent, Pa 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.
Reviews for FORT WORTH ENT, PA
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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 1336353366, we treat the final digit (6) 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FORT WORTH, TX 76104
FORT WORTH, TX 76104
FORT WORTH, TX 76104
FORT WORTH, TX 76104
FORT WORTH, TX 76104
FORT WORTH, TX 76104
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336353366, enumerated as an "organization" on May 09, 2007.
The provider is located at 1250 8TH AVE SUITE 135 FORT WORTH, TX 76104 and the phone number is (817) 335-8151.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
