NORTH TEXAS MOVEMENT DISORDERS INSTITUTE, INC – Neurology Physician, NPI 1689985038
Neurology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NORTH TEXAS MOVEMENT DISORDERS INSTITUTE, INC
621 PALO DURO DR
HURST, TX 760546009
Phone: (817) 886-0369
Fax: (817) 268-9011
Type: Mailing
PO BOX 2134
GRAPEVINE, TX 760992134
Phone: (214) 432-7549
Fax: (214) 432-6137
Type: Mailing
2004 BEDFORD RD
SUITE 100
BEDFORD, TX 760217011
Phone: (214) 432-7549
Fax: (214) 432-6137
Type: Location
4931 LONG PRAIRIE RD STE 100
FLOWER MOUND, TX 750282787
Phone: (817) 886-0369
Fax: (817) 268-9011
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-12-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20101229000111 | O | Clinic/Group Practice | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76054)
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