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AMBASSADOR PHYSICIAN GROUP LLC
NPI 1598856551
Nurse Practitioner - Gerontology in Fort Worth, TX

Active since September 27, 2006
6100 HARRIS PKWY, SUITE 250, FORT WORTH, TX 76132(817) 433-5179(817) 433-5177 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ambassador Physician Group Llc NPPES

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

AMBASSADOR PHYSICIAN GROUP LLC (NPI 1598856551) is a healthcare organization registered as a gerontology in Fort Worth, Texas and active in the NPI registry since September 2006. The organization lists Christopher David Cain, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1598856551
Entity TypeOrganization
Primary Taxonomy363LG0600X
Legal Business NameAMBASSADOR PHYSICIAN GROUP LLC
Location Address6100 HARRIS PKWY, SUITE 250Fort Worth, TX 76132-4101
Mailing Address6100 Harris Pkwy, Suite 250Fort Worth, TX 76132-4101 · (817) 433-5179 · Fax (817) 433-5177
Phone(817) 433-5179
Fax(817) 433-5177
Organization SubpartNo
Authorized OfficialChristopher David CainChief Operating Officer · (817) 975-4539
Enumeration DateSeptember 27, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1598856551 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in TX · 363LG0600X
6100 HARRIS PKWY, Fort Worth, TX 76132
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

MRS. ANJANETTE OSTROM AGACNP-BC
Nurse Practitioner (Acute Care)
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 433-5977
RAJKUMAR SOMASUNDARAM FNP-BC
Nurse Practitioner (Family)
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (490) 681-7820
HANSON INTERNAL MEDICINE, P.A.
Internal Medicine
6100 HARRIS PKWY, SUITE 240
FORT WORTH, TX 76132
Tarrant County (817) 504-5699
PAMELA J MAINOUS
Specialist/Technologist, Other (Surgical Assistant)
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 346-5000
DEVEN EMMANUEL GULICK MD
Internal Medicine
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 433-5977
GREGORY WAYNE HANSON M.D.
Internal Medicine
6100 HARRIS PKWY, SUITE 240
FORT WORTH, TX 76132
Tarrant County (817) 504-5699
LYNNE R TILKIN DO
Family Medicine
6100 HARRIS PKWY, STE 350
FORT WORTH, TX 76132
Tarrant County (817) 433-5580
DR. ILONA NEKHAYEVA MD., PHD
Family Medicine
6100 HARRIS PKWY
FORT WORTH, TX 76132
Tarrant County (817) 433-5977

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 Ambassador Physician Group LLC's NPI number?

The NPI number for Ambassador Physician Group LLC is 1598856551. It was assigned to this organization in the NPPES registry on September 27, 2006.

Where is Ambassador Physician Group LLC located?

Ambassador Physician Group LLC is located at 6100 Harris Pkwy Suite 250, Fort Worth, TX 76132. The listed phone number is (817) 433-5179.

What is Ambassador Physician Group LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Ambassador Physician Group LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.