SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY (NPI# 1790013787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790013787 |
| Entity Type | Organization |
| Organization Name | SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY |
| Other Organization Name | CAMPUS CLINIC |
| Practice Address |
4501 Stanley Ave Fort Worth TX 76115-2156 |
| Mailing Address |
Po Box 22480 Fort Worth TX 76122-0001 |
| Practice Telephone | 8179218880 |
| Practice Fax Number | 8179218881 |
| Mailing Telephone | 8179231921 |
| Mailing Fax Number | 8179218796 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |
| Authorized Official Name | MR. KEVIN D ENSLEY (VICE PRESIDENT FOR BUSINESS ADMINIS) |
| Authorized Official Telephone | 8179231921 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Campus Clinic | Other Name - Individual/Organization |
| Street Address |
4501 STANLEY AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76115-2156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922047786 | Richard Russell Knight | Emergency Medicine | 4501 Stanley Ave, Fort Worth, TX 76115-2156 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811400047 | Christine Vera Varela | Nurse Practitioner | Clinicas Mi Doctor, 4200 S Freeway Ste 106, Fort Worth, TX 76115 | 2017-11-09 |
| 1376081752 | Cheryl D. Mitchell | Nurse Practitioner | 11803 S. Freeway, Ste. 311, Fort Worth, TX 76115 | 2017-02-06 |
| 1508097858 | Misti Lynne Poulos | Massage Therapist | 4534 Stanley Ave, #361, Fort Worth, TX 76115 | 2009-08-04 |
| 1609015312 | Sirisha Bheemaneni | Internal Medicine | 11801 S Frwy, Fort Worth, TX 76115 | 2009-02-19 |
| 1639378292 | Jeffrey J. Raymond | Physician Assistant | 544 West Seminary Dr, Fort Worth, TX 76115 | 2007-07-13 |
| 1336367952 | Luis Sierra-nieves | Physician Assistant | 544 West Seminary Drive, Fort Worth, TX 76115 | 2007-04-20 |
| 1396861209 | Remedios R Cabansag | Obstetrics & Gynecology | 11803 So Freewax, Suite 254, Fort Worth, TX 76115 | 2007-03-22 |
| 1073602611 | Courage Rehab Clinic | Clinic/Center | 1670 North Hampton Road, Suite 110, Desoto, TX 76115 | 2006-10-12 |
| 1548369200 | Vijay Khanna | Podiatrist | 4759 B South Freeway, Ft Worth, TX 76115 | 2006-09-21 |
| 1225045164 | Allan M Wallace | Optometrist | 11803 South Frwy, Suite 114, Fort Worth, TX 76115 | 2006-08-02 |
| Find all providers in zip 76115 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470170 | Honestar Wound Care Pllc | Clinic/Center | 7908 Modena Dr, Fort Worth, TX 76126-6144 | 2020-09-01 |
| 1730731688 | Bebd Telehealth | Clinic/Center | 2009 Tremont Ave, Fort Worth, TX 76107-3959 | 2019-07-11 |
| 1821594045 | Goshen Family Clinic, Inc. | Clinic/Center | 5225 Hunters Ridge Rd, # 715, Fort Worth, TX 76132-1853 | 2018-04-05 |
| 1629527312 | Midtown Medical Imaging - Alliance | Clinic/Center | 9557 N. Beach St., Suite 101, Fort Worth, TX 76244 | 2016-09-23 |
| 1497008411 | Dr Mark Smith Pa | Clinic/Center | 7100 Oakmont Blvd. # 108, Fort Worth, TX 76132-3908 | 2012-10-16 |
| 1033461017 | Dr. Mark Smith Pa | Clinic/Center | 7100 Oakmont Bvld Suite 108, Fort Worth, TX 76132-3908 | 2012-10-15 |
| 1407049034 | University Family Medical Clinic P.a. | Clinic/Center | 117 University Dr, Fort Worth, TX 76107-1922 | 2007-08-27 |
| 1912045279 | Hmr Management Corporation | Clinic/Center | 901 W Leuda St, Fort Worth, TX 76104-3003 | 2007-02-01 |
| 1952396004 | Motus Center, Inc. | Clinic/Center | 3857 Washburn Ave, Fort Worth, TX 76107-3954 | 2005-09-14 |
| 1326539552 | Frontier Medical House Call Service LLC | Clinic/Center | 308 Autumn Park, Fort Worth, TX 76140 | 2018-05-23 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76115 |
Please comment or provide details below to improve the information on SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.