| NPI | 1083604458 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-10-26 |
| Last Updated | 2012-09-28 |
| Mailing Address | Po Box 650500 Dallas, TX 75265-0500 United States Phone: (214) 369-8555 | Fax: (214) 369-2683 📍 View Map |
| Primary Practice Address | 3900 Junius St, Suite 500 Dallas, TX 75246-1615 United States Phone: (214) 823-7090 | Fax: (214) 823-1644 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | TX | 152255901 | — |
| MEDICAID | TX | 152255902 | — |
| MEDICAID | TX | 152255903 | — |
| Other (non-Medicare) | TX | 8A5019 | BCBS |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207X00000X – Orthopaedic Surgery | TX | K3615 |
| No | 207XS0106X – Orthopaedic Surgery, Hand Surgery | TX | K3615 |
| No | 207XS0114X – Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | TX | K3615 |
| No | 207XX0005X – Orthopaedic Surgery, Sports Medicine | TX | K3615 |
| No | 207XX0801X – Orthopaedic Surgery, Orthopaedic Trauma | TX | K3615 |
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About NPI 1083604458
Virgil B Medlock MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1083604458. The primary specialty listed is Orthopaedic Surgery. The provider is located in Dallas, TX. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-10-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1083604458?
NPI 1083604458 belongs to Virgil B Medlock MD, a Orthopaedic Surgery in Dallas, TX. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1083604458 active?
The current status of NPI 1083604458 in the NPPES registry is Active. The record was last updated on 2012-09-28.
What specialty is NPI 1083604458?
NPI 1083604458 is classified under the taxonomy Orthopaedic Surgery. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1083604458?
You can verify NPI 1083604458 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1083604458?
The primary practice address on file for NPI 1083604458 is 3900 Junius St, Dallas, TX 75246-1615. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1083604458 issued?
NPI 1083604458 was first issued (enumerated) on 2005-10-26. The NPPES record was last updated on 2012-09-28.
Practice Location Map
Virgil B Medlock is located at 3900 Junius St, Dallas, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Virgil B Medlock. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1083604458. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Orthopaedic Surgery | K3615 | TX |
| Orthopaedic Surgery, Hand Surgery | K3615 | TX |
| Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | K3615 | TX |
| Orthopaedic Surgery, Sports Medicine | K3615 | TX |
| Orthopaedic Surgery, Orthopaedic Trauma | K3615 | TX |