MR. STEVEN ROBERT SOUDERS (NPI# 1871979674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871979674 |
| Entity Type | Individual |
| Full Name | MR. STEVEN ROBERT SOUDERS |
| Credential | PA-C |
| Practice Address |
3124 N Tarrant Pkwy Ste 200 Fort Worth TX 76177-8618 |
| Mailing Address |
Po Box 77222 Fort Worth TX 76177-0222 |
| Practice Telephone | 8175027411 |
| Practice Fax Number | 8175027412 |
| Mailing Telephone | (817) 502-7411 |
| Mailing Fax Number | 8175027412 |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2017-06-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | PA09955 | TX | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8874NV | 01 |
| TX | DEA | MS3663336 | 01 |
| Street Address |
3124 N TARRANT PKWY STE 200 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76177-8618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225685449 | Cody Brown Dds Pllc | Dentist | 2701 W Heritage Trace Pkwy, Ste 130, Fort Worth, TX 76177 | 2019-08-22 |
| 1144782889 | Daniel Max & Marcandrea LLC | Optometrist | 8901 N. Freeway Service Rd E, Ste 105, Fort Worth, TX 76177 | 2019-04-02 |
| 1194296202 | Fresenius Medical Care Keller, LLC | Clinic/Center | 3700 N Tarrant Pkwy, Fort Worth, TX 76177 | 2018-12-16 |
| 1861961310 | Daniel Max & Marcandrea, LLC | Optometrist | 3524 Highway 114, Suite 300, Forth Worth, TX 76177 | 2018-11-14 |
| 1447732896 | Alexis Etienne Ingleton | Assisted Living Facility | 15840 Badger Creek Lm, Fort Worth, TX 76177 | 2018-09-02 |
| 1023526365 | J&l Dental Group, Pllc | Clinic/Center | 2401 Heritage Trace Parkway, Suite 121, Fort Worth, TX 76177 | 2018-01-22 |
| 1689115438 | Hayley Blackwood | Psychologist | 15833 Bent Rose Way, Fort Worth, TX 76177 | 2017-03-13 |
| 1013463256 | Elianne Griselle Alarcon | Dentist | 8917 N. Freeway, Suite 117, Fort Worth, TX 76177 | 2016-08-28 |
| 1962877373 | Home Town Dental Alliance | Dentist | 8901 Tehama, Suite 119, Forth Worth, TX 76177 | 2015-12-10 |
| 1003280686 | Susan Akberzie | Nurse Practitioner | 3400 Texas Sage Trl Ste 148, Fort Worth, TX 76177 | 2015-11-19 |
| Find all providers in zip 76177 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596927 | Emily Lau | Physician Assistant | 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 | 2020-10-20 |
| 1629681952 | Anum Bashwani | Physician Assistant | 5601 Bridge St Ste 450, Fort Worth, TX 76112-2305 | 2020-08-26 |
| 1780200881 | Emily Brown Holloway | Physician Assistant | 1904 Turner Ridge Dr Apt 5202, Fort Worth, TX 76110-2499 | 2020-06-24 |
| 1679196570 | Maria Cristela Mosso | Physician Assistant | 4521 S Hulen St Ste 118, Fort Worth, TX 76109-4954 | 2020-05-26 |
| 1679195978 | Jacob Torre | Physician Assistant | 1701 River Run Ste 1118, Fort Worth, TX 76107-6557 | 2020-05-11 |
| 1871122382 | Kenaud Jeune | Physician Assistant | 5817 Fairglen Ave Apt 312, Fort Worth, TX 76137-6810 | 2020-04-06 |
| 1922635648 | Lauren Elizabeth Studey | Physician Assistant | 3470 Sagecrest Ter, Fort Worth, TX 76109-2555 | 2020-03-24 |
| 1033743612 | James Bregg Reedy | Physician Assistant | 200 W Magnolia Ave Ste 201, Fort Worth, TX 76104-7657 | 2020-02-24 |
| 1992335194 | Alexandria Christine Rios | Physician Assistant | 5904 Rockhill Rd, Fort Worth, TX 76112-3047 | 2020-01-16 |
| 1982253605 | Kelly Ann Klein | Physician Assistant | 6708 River Bend Rd, Fort Worth, TX 76132-1108 | 2019-09-05 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76177 |
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| 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.