CENTERWELL SENIOR PRIMARY CARE-NORTH BUCKNER
NPI 1649919929
Internal Medicine in Dallas, TX

Active since June 03, 2022
3312 N BUCKNER BLVD STE 213, DALLAS, TX 75228(469) 998-0720(877) 692-4919 Get Directions Write a Review

NPPES record last updated: October 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Centerwell Senior Primary Care-north Buckner NPPES

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

CENTERWELL SENIOR PRIMARY CARE-NORTH BUCKNER (NPI 1649919929) is a healthcare organization registered as an internal medicine in Dallas, Texas and active in the NPI registry since June 2022. The organization lists Angie Martinez, Senior Credentialing Professional, as its authorized official.

NPPES Registry Identity

NPI1649919929
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCENTERWELL SENIOR PRIMARY CARE (TX) PA
Location Address3312 N BUCKNER BLVD STE 213Dallas, TX 75228-5642
Mailing Address4700 Millenia Blvd Ste 650Orlando, FL 32839-6013 · (407) 447-7120 · Fax (407) 770-0661
Fax(877) 692-4919
Organization SubpartYesParent: Centerwell Senior Primary Care Tx Pa
Authorized OfficialAngie MartinezSenior Credentialing Professional · (407) 447-7120
Enumeration DateJune 3, 2022
Last NPPES UpdateOctober 18, 2022
NPPES CertifiedOctober 18, 2022
NPI 1649919929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
3312 N BUCKNER BLVD STE 213, Dallas, TX 75228

Other Names 1

Doing Business AsCenterwell Senior Primary Care-north Buckner

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 of Waiver 45D2265778

Centerwell Senior Primary Care - North Buckner · Dallas, TX
Expired · Aug 1, 2026
CLIA Number45D2265778
Laboratory TypePhysician Office
Certificate Effective DateAugust 2, 2024
Certificate Expiration DateAugust 1, 2026
Laboratory DirectorAn Thien Tang
Laboratory Phone(469) 998-0720
Laboratory LocationCenterwell Senior Primary Care - North Buckner3312 N Buckner Blvd Suite 213, Dallas, TX 75228
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Family Medicine
3312 N BUCKNER BLVD STE 213
DALLAS, TX 75228
Nurse Practitioner (Family)
3312 N BUCKNER BLVD STE 213
DALLAS, TX 75228

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 Centerwell Senior Primary Care (tx) PA's NPI number?

The NPI number for Centerwell Senior Primary Care (tx) PA is 1649919929. It was assigned to this organization in the NPPES registry on June 3, 2022. The provider is doing business as Centerwell Senior Primary Care-North Buckner.

Where is Centerwell Senior Primary Care (tx) PA located?

Centerwell Senior Primary Care (tx) PA is located at 3312 N Buckner Blvd Ste 213, Dallas, TX 75228. The listed phone number is (469) 998-0720.

What is Centerwell Senior Primary Care (tx) PA's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Centerwell Senior Primary Care (tx) PA was last updated on October 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.